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Cholecystectomy-related complaints: a 20-year review of the Canadian medicolegal experience
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Cholecystectomy-related complaints: a 20-year review of the Canadian medicolegal experience
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Journal Article
Cholecystectomy-related complaints: a 20-year review of the Canadian medicolegal experience
2025
Overview
Background: Laparoscopic cholecystectomy remains one of the procedures most commonly performed by general surgeons in Canada. Significant complications after cholecystectomy are rare but can have devastating consequences on the patient, surgeon, and healthcare system. This is especially true for common bile duct injuries (BDIs). This study aimed to provide a 20-year review and examination of trends in Canadian medicolegal data related to postcholecystectomy complaints. Methods: This was a 20-year retrospective review of the Canadian Medical Protective Association's (CMPA) repository of medicolegal cases involving cholecystectomy-related complaints between 2003 and 2022. Cases included all those in which the physician contacted the CMPA for assistance, including civil legal actions, medical regulatory complaints, and hospital complaints. Data analysis was limited to descriptive statistics using SAS software. Results: A total of 488 cases were closed, with initial events occurring from 1991 to 2021. There was a trend of decreasing complaints during the study period (p = 0.0004), with the majority of patients identifying as female (66%) and being generally healthy (ASA grade I/II 73.6%). The top 5 complications leading to complaint initiation were BDI (35.9%), leak (15.2%), bowel injury (12.7%), sepsis (10.9%), and hemorrhage (10.2%). A total of 555 physicians were involved, with 484 operating surgeons named in complaints. Most surgeons (70%) had been in practice for 11 years or more. The mean time from incident to case closure was 63.2 + 42.3 months. Cases of BDI were significantly more likely to result in a favourable medicolegal outcome for the patient (77%) compared to all cholecystectomy cases (54%). Conclusion: This study demonstrated that the majority of postcholecystectomy complaints involved generally healthy female patients. Unsurprisingly, BDI was the most common complication resulting in a complaint, and these cases were more likely to result in a successful claim for the patient. Surgeons later in practice were more likely to be named in a complaint than their colleagues early in practice.
Publisher
CMA Impact, Inc
Subject
