Cirocchi Roberto, Panata Laura, Griffiths Ewen A, Tebala Giovanni D, Lancia Massimo, Fedeli Piergiorgio, Lauro Augusto, Anania Gabriele, Avenia Stefano, Di Saverio Salomone, Burini Gloria, De Sol Angelo, Verdelli Anna Maria
Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy.
Legal Medicine and Insurance Office, Santa Maria della Misericordia Hospital, 06129 Perugia, Italy.
J Clin Med. 2021 Nov 10;10(22):5238. doi: 10.3390/jcm10225238.
To define what type of injuries are more frequently related to medicolegal claims and civil action judgments.
We performed a scoping review on 14 studies and 2406 patients, analyzing medicolegal claims related to laparoscopic cholecystectomy injuries. We have focalized on three phases associated with claims: phase of care, location of injuries, type of injuries.
The most common phase of care associated with litigation was the improper intraoperative surgical performance (47.6% ± 28.3%), related to a "poor" visualization, and the improper post-operative management (29.3% ± 31.6%). The highest rate of defense verdicts was reported for the improper post-operative management of the injury (69.3% ± 23%). A lower rate was reported in the incorrect presurgical assessment (39.7% ± 24.4%) and in the improper intraoperative surgical performance (21.39% ± 21.09%). A defense verdict was more common in cystic duct injuries (100%), lower in hepatic bile duct (42.9%) and common bile duct (10%) injuries.
During laparoscopic cholecystectomy, the most common cause of claims, associated with lower rate of defense verdict, was the improper intraoperative surgical performance. The decision to take legal action was determined often for poor communication after the original incident.
确定何种类型的损伤更常与法医学索赔和民事诉讼判决相关。
我们对14项研究和2406名患者进行了范围综述，分析与腹腔镜胆囊切除术损伤相关的法医学索赔。我们重点关注与索赔相关的三个阶段：护理阶段、损伤部位、损伤类型。
与诉讼相关的最常见护理阶段是术中手术操作不当（47.6%±28.3%），与“视野不佳”有关，以及术后管理不当（29.3%±31.6%）。损伤术后管理不当的辩护裁决率最高（69.3%±23%）。术前评估不正确（39.7%±24.4%）和术中手术操作不当（21.39%±21.09%）的裁决率较低。在胆囊管损伤中辩护裁决更为常见（100%），在肝内胆管损伤（42.9%）和胆总管损伤（10%）中较低。
在腹腔镜胆囊切除术中，索赔的最常见原因是术中手术操作不当，其辩护裁决率较低。采取法律行动的决定通常是由于最初事件后沟通不畅。
