Approximately 750,000 laparoscopic cholecystectomies are performed each year for gallbladder removal and despite improvements in surgical procedures to prevent bile duct injuries, mistakes still occur in approximately 1 out of 200 cases that result in death or diminished quality of life for the patient, according to Edward P. Milstein, partner in bile duct surgery and top medical new york malpractice law firm of Dankner Milstein, P.C.
“The most common injury usually involves the misidentification of the common bile duct as the cystic duct,” Milstein, who has handled numerous cases stemming from complications of gallbladder surgery, said. “The cystic duct may be obscured in some patients undergoing laparoscopic cholecystectomy especially in the presence of inflammation. The deceptive appearance of the biliary anatomy may mislead the surgeon into identifying the common bile duct as the cystic duct.”
Milstein is of the opinion that common bile duct injuries (tears to complete transections) can be completely avoided by the laparoscopic surgeon.
“For the last 20 years,” he explained, “it has been the accepted practice to identify the cystic structures by employing the critical view of safety. This technique has 3 requirements. First, the Triangle of Calot must be cleared of all fat. Secondly, the lowest part of the gallbladder must be separated from the surface to which the gallbladder is attached. And lastly, only 2 structures should be seen entering the gallbladder: the cystic duct and artery.
“Once these requirements have been met,” he added, “the critical view of safety has been achieved and it is safe to ligate these structures.”
In Milstein’s view, that failure to identify the critical view of safety leading to biliary injury is an absolute deviation from the standard of care.
“When proper techniques are employed by the surgeon,” Milstein said, “injuries to the common bile duct can not and should not occur. If injury to the common bile duct occurs, the surgeon did not employ acceptable techniques in performing the procedure and is guilty of committing malpractice.”
If you think you have been the victim of gallbladder removal malpractice, you should contact one of our lawyers at Dankner Milstein for a free consultation at 212-751-8000 or office@dmesq.com. Our firm has recovered more than $500 million for clients we’ve represented; and has secured more than two hundred (200) verdicts and settlements of one million dollars or higher.
