Bile duct injuries can occur during abdominal surgery, particularly during procedures to remove the gallbladder. While damage to the bile ducts is a recognised complication of gallbladder surgery, in some circumstances an injury may have been avoidable or may not have been identified and treated appropriately.
If you have experienced a bile duct or hepatic injury following surgery and are concerned about the treatment you received, Ison Harrison’s clinical negligence solicitors can help you understand what may have happened and whether your circumstances should be investigated.
What are bile duct and hepatic injuries?
The bile ducts are small tubes that carry bile from the liver and gallbladder to the small intestine. Bile helps the body digest fats.
There are several ducts within the biliary system. These include the hepatic ducts, which drain bile from the liver, and the common bile duct, which carries bile towards the small intestine.
Because these structures are located close to the gallbladder, they can potentially be damaged during gallbladder surgery. The nature and extent of an injury can vary considerably, and the treatment required will depend on the individual circumstances.
Common bile duct injuries during surgery
A common bile duct injury is a recognised complication of gallbladder removal surgery, also known as a cholecystectomy.
During the operation, the surgeon needs to identify the structures around the gallbladder carefully before they are divided or clipped. Inflammation, scarring or variations in a person’s anatomy, (either a natural variation between patients or because of previous gastric or abdominal surgery has altered the patient’s internal anatomy) can sometimes make this more difficult. Often, a cholecystectomy is performed via keyhole surgery, and the limited field of view can make identifying the correct structures difficult. In this scenario, it is often necessary to convert the procedure to an open surgery with a larger incision to gain a better field of view. Failing to convert to an open surgery can form the basis of negligent care.
If a patient has had previous abdominal surgery this can change the landmarks that surgeons will look for to identify the different structures. Being aware of any changes or the likelihood of an altered anatomy in advance is essential so the surgeon can orientate themselves or consider whether they have sufficient knowledge and skill to perform the procedure before undertaking it.
A bile duct injury may be identified during surgery, but it can also become apparent afterwards.
Not every bile duct injury is the result of clinical negligence. However, where an injury occurred because the appropriate standard of care was not provided, or where a complication was not recognised and managed appropriately, it may be appropriate to investigate whether there has been clinical negligence.
What are the symptoms of a bile duct injury?
The symptoms of a bile duct injury can vary depending on the type of injury and when it occurs.
Following surgery, symptoms that may require further medical investigation can include:
- Abdominal pain or discomfort
• Abdominal swelling
• Nausea or vomiting
• Fever or feeling generally unwell
• Jaundice, including yellowing of the skin or eyes
• Changes in bowel movements
• A bile leak
• Abnormal liver function blood tests
These symptoms can have a number of possible causes and do not necessarily mean that a bile duct injury has occurred.
If you are experiencing worrying symptoms following surgery, you should seek medical advice. If you are concerned that your symptoms were not investigated or treated appropriately, our team can advise you about the legal position.
How can a bile duct injury happen?
There are a number of circumstances in which a bile duct injury may need to be investigated.
These can include:
- Damage to the bile duct or hepatic duct during gallbladder surgery
• The bile duct being incorrectly identified during an operation
• An injury not being recognised during surgery
• A bile leak not being identified or appropriately managed
• A failure to investigate symptoms following surgery
• A delay in diagnosing or treating complications
• Further surgery being required because of an injury that may have been avoidable
Whether an injury amounts to clinical negligence will depend on the individual circumstances and the medical evidence.
What treatment may be required?
Treatment following a bile duct or hepatic injury will depend on the nature and extent of the injury.
Some injuries may be managed with monitoring or less invasive treatment, while others may require procedures such as endoscopic treatment, drainage or further surgery.
For some patients, specialist treatment may be necessary to repair the damaged bile duct or restore the normal flow of bile. Recovery can therefore vary significantly from one person to another.
The NHS recognises bile duct damage and bile leakage as possible complications of gallbladder removal, and some patients require further treatment when these complications occur.
Could I make a clinical negligence claim?
A bile duct injury does not automatically mean that clinical negligence has occurred.
To establish a clinical negligence claim, it is generally necessary to show that the treatment provided fell below the appropriate standard and that this caused injury or additional loss.
When investigating a potential claim, it may be necessary to consider what happened before, during and after your surgery. This can include reviewing your medical records and obtaining independent medical evidence.
Questions that may need to be considered include:
- Was a sufficient history taken and consideration given to previous abdominal surgeries?
- Was the surgery carried out to an appropriate standard?
- Was the relevant anatomy correctly identified?
- Should the surgery have been converted to an open procedure?
- Should the injury have been avoided?
- Should the injury have been identified during the operation?
- Were symptoms after surgery investigated appropriately?
- Was any bile leak or other complication treated promptly?
- Did any delay contribute to additional injury or treatment?
These questions can only be answered properly by looking at the individual circumstances and the available medical evidence.
How can Ison Harrison help?
Our clinical negligence team has experience dealing with complex claims involving surgical injuries and complications.
We understand that it can be difficult to know whether something that happened during surgery was an unavoidable complication or whether mistakes may have been made.
We can help investigate your treatment and explain whether there may be grounds for a clinical negligence claim.
Contact our clinical negligence team
If you have experienced a bile duct, hepatic duct or common bile duct injury and are concerned about the treatment you received, our clinical negligence solicitors can discuss your circumstances with you.
You do not need to know whether negligence has occurred before getting in touch.
We can help you understand what information is needed and whether your circumstances may warrant further investigation. Speak to our clinical negligence team today – call 0113 284 5000 or email clinneg@isonharrison.co.uk.
