Colorectal Surgery Expert Comments on Necrotizing Pancreatitis After Laparoscopic Cholecystectomy

Case Overview

This case involves a female patient who suffered multiple complications including persistent bile leakage and necrotizing pancreatitis following a laparoscopic cholecystectomy. She presented to the emergency room complaining of abdominal pain, heartburn and indigestion. She was discharged home with prescriptions for a painkiller and antacids. She was instructed to return to the emergency room if her symptoms persisted. She was seen for follow-up some time later, where she was noted to have had persistent pain and discomfort since surgery. Imaging was performed, which discovered potential evidence of a bile leak. The patient was not admitted at that time, but returned to the hospital later on, complaining of episodic abdominal pain. Another scan was concerning for a bile leak, and the patient was transferred to another medical center per the Defendant’s instructions. Here, the patient underwent an endoscopic procedure to repair the leak. The patient continued to have a persistent leakage as well as pancreatitis until she ultimately developed necrotizing pancreatitis.

Questions to the General Surgery expert and their responses

Do you routinely treat patients similar to the one described in the case?

I routinely see patients with bile leaks post cholecystectomy - it is a fairly common complication of cholecystectomy. I am well qualified to opine on the management of bile leaks and any deviations from the standard of care.

Have you ever had a patient develop an outcome similar to the one described in the case?

In this case there appears to be a deviation from the standard of care, given the fact that the patient continued to experience these symptoms for such an extended period of time.

Are bile leaks a common complication of the procedure?

I routinely see patients with bile leaks post cholecystectomy - it is a fairly common complication of cholecystectomy. The presence of an anomalous Duct of Luscka is also fairly common.

About the expert

This highly qualified expert is board certified in General Surgery and Colon and Rectal Surgery. He earned his BS from Oklahoma State University and his MD from New York Medical College. He completed a residency in General Surgery and fellowship in Colon and Rectal Surgery at LSU. He is a veteran of the US Army and while in the Army, he served as Chief of Professional Services before moving to a major university medical center. He is well published, with over a dozen peer reviewed journal articles and numerous presentations. In addition to his clinical duties, he is actively involved in the education of medical students and residents.