Comparative analysis of iatrogenic lesion of bile ducts in conventional and videolaparoscopic cholecystectomies

Fortunato, André Augusto; Caetano, Diogo Peral; Aurélio, Marcus; Gomes, Zaia; Bassi, Marco

doi:10.5935/2238-3182.20140137

Cited by 2 publications

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References 15 publications

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“…Conclusão: A intenção de litigar e a litigância após LIVB foram elevadas e a relação médico/paciente transparente com a boa governança clínica parecem ser a melhor forma de mitigá-las. (FORTUNATO et al, 2014).…”

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Fatores associados à vontade de litigar e ao litígio judicial após lesão iatrogênica da via biliar

Filho¹,

Mundim²

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Introduction:The factors associated with ethical and legal questions due to iatrogenic bile duct injuries (IBDI) may offer subsidies to the doctor/patient relationship and provide a basis for opinions and decisions in litigations. Objective: To identify factors associated with the intent to litigate and with legal litigation after IBDI. Method: This was a study of IBDI cases treated at a tertiary care teaching public hospital between 2003 and 2018, based on the application of questionnaires for patients and doctors aiming at the characteriation of care circumstances, of the results of treatment and of the considered and petitioned legal processes. The associations were determined by the Fisher exact test, with the level of significance set at 0.05. Results: Seventy-one of the 144 patients treated for IBDI were studied: 33 (46.5%) were operated for symptomatic cholelithiasis,31 (43.7%) for acute cholelithiasis, and 7 (9.8%) for asymptomatic cholelithiasis. Mean age was 46.14 (18-75) years; 62 (87.3%) patients were females, and 59 (83.0%) had low and medium schooling. Referral for IBDI treatment was coordinated by the surgeon in 50 (70.4%) patients, by relatives in 11 (15,5%), and by assistance regulation in 9 (12.7%). Bile obstruction was resolved in 58 (81.7%) cases; 13 (18.3%) progressed to cholangitis and 2 (2.8%) to biliary cirrhosis and portal hypertension. Treatment was considered excellent and good for 58 patients (81.7%). The intent to litigate was expressed by 16 (22.5%) patients and was significantly associated with lower family income, with failure to give written informed consent, with lack of knowledge of the surgical risks and complications, with lack of postoperative counseling, and with the persistence of biochemical changes compatible with cholestasis. Litigation was the option for 7 patients (9.9%) and was significantly associated with a lower possibility of endoscopic treatment, with doubts about the evolution of IBDI and with the persistence of biochemical changes compatible with cholestasis. Of the 7 legal trials, 2 were dismissed, 2 were in the initial phases, and 3 were occurring under secret. Conclusion:The intent to litigate and litigation after IBDI were high and a transparent doctor/patient relationship with good clinical conduct appeared to be the best way to mitigate them.

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Fatores associados à vontade de litigar e ao litígio judicial após lesão iatrogênica da via biliar

Filho¹,

Mundim²

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Diagnosis and Treatment of Post-Cholecystectomy Iatrogenic Biliary Injury: A Retrospective Study

Fayek¹,

Ezzat

2020

The Medical Journal of Cairo University

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Background: Preventive strategies and safe surgery are of utmost importance to minimize BDI during cholecystectomy. The importance of frank communication with the patient and accurate documentation cannot be overemphasized. Diagnosis requires a high index of suspicion with focused clinical, biochemical, and radiological examination. Aim of Study: Is to evaluate the best protocol in management of iatrogenic biliary injuries sustained during either laparoscopic or open cholecystectomy. Patients and Methods: 40 patients with iatrogenic bile duct injuries following cholecystectomy (open and Laparoscopic) referred to the

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Comparative analysis of iatrogenic lesion of bile ducts in conventional and videolaparoscopic cholecystectomies

Cited by 2 publications

References 15 publications

Fatores associados à vontade de litigar e ao litígio judicial após lesão iatrogênica da via biliar

Fatores associados à vontade de litigar e ao litígio judicial após lesão iatrogênica da via biliar

Diagnosis and Treatment of Post-Cholecystectomy Iatrogenic Biliary Injury: A Retrospective Study

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