Laparoscopic cholecystectomy error causes pancreatic duct leak


pancreasThis case takes place in Indiana and involves a 69 year old female who underwent a  laparoscopic cholecystectomy with placement of stent. At time of stent removal, ERCP determines stent has migrated to the small bowel. Report of ERCP indicates that the main pancreatic duct was inadvertently injected twice. The patient was sent home, where her condition deteriorated and three days later she found herself back in the hospital diagnosed with post-ERCP pancreatitis and an evolving pseudocyst. After several days, she is transferred to a tertiary care facility where another ERCP confirms a pancreatic duct leak. Though she was placed on the Pancreas transplant list as a precaution, her condition recovered well enough to not necessitate a transplant. However, it continued to impact her quality of life to the extent that she filed suit against her doctors, alleging that they had been negligent in their care.

Question(s) For Expert Witness

  • Could the complications due to a delayed diagnosis have been avoided?

Expert Witness Response E-004465

This is a classic case in which the physicians act too cautiously with diagnostic studies when the diagnosis is already made. The pancreatic pseudocyst should not have been giving the chance to develop and the pancreatic leak should have been addressed sooner. Yes it looks like the complications could have been prevented in this case.

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