英国和爱尔兰腹腔镜胆囊切除术后的法医学索赔。
Medicolegal claims following laparoscopic cholecystectomy in the UK and Ireland.
作者信息
Scurr James R H, Brigstocke Julian R, Shields David A, Scurr John H
机构信息
Mersey School of Surgery, UK.
出版信息
Ann R Coll Surg Engl. 2010 May;92(4):286-91. doi: 10.1308/003588410X12664192076214.
INTRODUCTION
The causes and outcomes of medicolegal claims following laparoscopic cholecystectomy were evaluated.
SUBJECTS AND METHODS
A retrospective analysis of the experience of a consultant surgeon acting as an expert witness within the UK and Ireland (1990-2007).
RESULTS
A total of 151 claims were referred for an opinion. Sixty-three related to bile duct injuries and four followed major vascular injury. Bowel injury resulted in 17 claims. A postoperative biliary leak not associated with a bile duct injury was responsible for 25 claims. Other reasons for claims included spilled gallstones, port-site herniae, haemorrhage and other recognised complications associated with laparoscopic cholecystectomy. Twelve of the claims are on-going, two went to trial, 79 (52%) were settled out of court and 58 (38%) were discontinued after the claimants were advised that they were unlikely to win their case. Disclosed settlement amounts are reported.
CONCLUSIONS
Bile duct and major vascular injuries are almost indefensible. The delay in diagnosis and (mis)management of other recognised complications following laparoscopic cholecystectomy have also led to a significant number of successful medicolegal claims.
引言
对腹腔镜胆囊切除术后医疗法律索赔的原因及结果进行了评估。
对象与方法
对一位顾问外科医生在英国和爱尔兰担任专家证人的经历（1990 - 2007年）进行回顾性分析。
结果
共收到151项索赔请求以征求意见。其中63项与胆管损伤有关，4项继发于重大血管损伤。肠道损伤导致17项索赔。与胆管损伤无关的术后胆漏导致25项索赔。索赔的其他原因包括胆结石溢出、穿刺孔疝、出血以及其他与腹腔镜胆囊切除术相关的公认并发症。12项索赔仍在进行中，2项进入审判阶段，79项（52%）庭外和解，58项（38%）在原告被告知胜诉可能性不大后撤诉。报告了已披露的和解金额。
结论
胆管和重大血管损伤几乎无法辩护。腹腔镜胆囊切除术后其他公认并发症的诊断延迟及（错误）处理也导致了大量成功的医疗法律索赔。
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