AI Article Synopsis
- This study analyzed bile duct injuries (BDI) after gallbladder surgery, focusing on the risk factors leading to malpractice lawsuits.
- Out of 211 patients treated for BDI, 36.7% pursued litigation, often with significant payouts; delays in referral to specialized care were strongly linked to higher litigation rates.
- Key findings suggest that timely referrals to experienced centers without prior repair attempts can lower the chances of legal action.
Article Abstract
Background: Bile duct injury (BDI) following cholecystectomy is associated with malpractice litigation. Aim of this study was to evaluate risk factors for litigation in patients with BDI referred in a tertiary care center.
Methods: Patients treated for BDI between 1994 and 2016. Stabilized inverse probability therapy weighting was used and multivariable logistic regression analysis identified risk factors for malpractice litigation.
Results: Of the 211 treated patients, 98 met the inclusion criteria: early-referral group (<20 days; 51.0%), late-referral (≥20 days; 49.0%). 36 patients (36.7%) initiated malpractice litigation with verdict in favor of plaintiff in 86.7% of cases (median payment = €90 500, up to €600 000). Attempts at surgical and endoscopic repair before referral were significantly higher in late-referral group. Failed postoperative management (delayed referral, attempts at repair before referral) was one of the strongest predictors for litigation. Risk of litigation progressively increased from 23.8%, when referral time was within 19 days, to 54.5% (61-120 days), to 60.0% (121-210 days) and to 65.1% (211-365 days).
Discussion: Litigation rate after BDI was 37%. Delayed referral to tertiary care center was one of the strongest predictors for litigation. Prompt referral to tertiary experienced centers without any attempt at repair may reduce the risk of litigation.
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| http://dx.doi.org/10.1016/j.hpb.2023.01.005 | DOI Listing |
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