Gallbladder Surgery Causing Serious Liver Injury

The gallbladder stores bile between meals. It concentrates the bile by absorbing water. That increases the risk for gallstones to form. These cause severe inflammation and pain.

When the gallbladder contracts after a fatty meal (where its bile is used to help in the digestion of fat), its contraction can also cause pain from gallstones.

During Gallbladder surgery (cholecystectomy) preventable injury can result in damage to the main (common) bile duct that connects the liver with the gallbladder and first part of the small intestine (duodenum).

The gallbladder is attached to the under surface of the liver. Its lowermost end drains into a narrow tube (the cystic duct). The cystic duct drains directly into the main bile duct. Before the cystic duct is cut, the surgeon must identify the main (common) bile duct. Injury to the common bile duct is a disaster, because if it is immediately repaired at that time, it often heals with severe scare tissue formation that can cause a blockage of bile flow. This impaired bile flow also increases the risk of a potentially fatal infection (cholangitis), as well as liver failure (obstructive jaundice).

If the surgeon attempts to perform the cholecystectomy operation using the laparoscopic instruments and cannot accurately discern the junction of the cystic duct with the common bile duct, then he must stop and perform the incision to open up the abdomen (laparotomy), and proceed under direct vision and feel.

Severing the common bile duct and not recognizing that injury is even more egregious. The patient will develop progressive yellow jaundice and liver failure from the ligated (tied or clipped) common bile duct. The surgery to repair that injury requires a great skill. A segment of the small intestine (jejunum) is used as a conduit between the remaining upper portion of the common bile duct and the intestines. But this connection (anastomosis) frequently scars closed requiring a lifetime of repetitive operations and serious risk of liver duct infections (cholangitis).

In addition to the danger of injury to the common bile duct, the hepatic (liver) artery also is located at the lowermost section of the gallbladder and must be properly identified and protected. It must not be ligated instead of the cystic (gallbladder) artery. Otherwise, liver failure could result, causing death from a gangrenous liver.

This medical malpractice article was written by an expert witness working with American Medical Experts, LLC (AME). AME is the nation’s leading source of medical experts for case review and testimony; AME also offers the lowest flat rate fees on Complete Case Reviews ($695) and Expert Witness Reports ($995). For more information, call 888-678-EXPERTS (888-678-3973) or visit AmericanMedicalExperts.com.