Is a surgeon protected when treating complications after a previous operation? (a case study of treating patients with injuries and strictures of the extrahepatic bile ducts)

Objective: to analyze the legal and professional protection of surgeons performing operations to treat complications after primary interventions on the extrahepatic bile ducts, using the example of treating patients with injuries and strictures.

Materials and methods. A retrospective analysis of the treatment of 123 patients who underwent reconstructive surgery between 2000 and 2024 was conducted. Statistical analysis methods, including χ² tests and Yates's correction, were used to evaluate the results. The study included an examination of surgical techniques, treatment tactics, and legal aspects of medical documentation.

Results. Injuries and strictures of the extrahepatic bile ducts most often occurred during laparoscopic cholecystectomy and gastric resection. The main complications were associated with the anatomical features of the ducts, inflammatory changes, and insufficient qualifications of surgeons. Hepaticoenterostomy with a replaceable transhepatic drain was recognized as the most effective treatment method, with a mortality rate of 9.8%. However, with external drainage, mortality reached 66–80%. Long-term results showed that the frequency of anastomotic strictures was minimal (1.37%) with transhepatic drainage.

Conclusions. The success of treating complications of the extrahepatic bile ducts depends on the level of professionalism of surgeons, the applied treatment methods, and their compliance with modern standards. To reduce legal risks, it is important to correctly describe complications in medical documentation. The authors emphasize the need for regular analysis of medical errors and improvement of the system of training surgeons.

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