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Medicolegal claims following laparoscopic cholecystectomy in the UK and Ireland.

INTRODUCTION
The causes and outcomes of medicolegal claims following laparoscopic cholecystectomy were evaluated.


SUBJECTS AND METHODS
A retrospective analysis of the experience of a consultant surgeon acting as an expert witness within the UK and Ireland (1990-2007).


RESULTS
A total of 151 claims were referred for an opinion. Sixty-three related to bile duct injuries and four followed major vascular injury. Bowel injury resulted in 17 claims. A postoperative biliary leak not associated with a bile duct injury was responsible for 25 claims. Other reasons for claims included spilled gallstones, port-site herniae, haemorrhage and other recognised complications associated with laparoscopic cholecystectomy. Twelve of the claims are on-going, two went to trial, 79 (52%) were settled out of court and 58 (38%) were discontinued after the claimants were advised that they were unlikely to win their case. Disclosed settlement amounts are reported.


CONCLUSIONS
Bile duct and major vascular injuries are almost indefensible. The delay in diagnosis and (mis)management of other recognised complications following laparoscopic cholecystectomy have also led to a significant number of successful medicolegal claims.