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.
Graphical abstract
Graphical Abstract
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Article info
Publication history
Published online: January 17, 2023
Accepted:
January 16,
2023
Received:
August 18,
2022
Footnotes
☆The paper was presented at the 15th IHPBA World Congress (March 30 - April 2, 2022 New York City, United States).
Identification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
