Roux-en-Y Reconstruction for Lap Choly Injuries During Gallbladder Surgery

One of the more common laparoscopic cholecystectomy repairs Trief & Olk has encountered due to medical malpractice is a surgery known as a Roux-en-Y reconstruction, or simply a Roux-en-Y. During a Roux-en-Y, the hepatic or biliary duct is connected directly to the small intestines. The purpose is to compensate for the inability for bile to flow freely due to biliary duct injury during a laparoscopic cholecystectomy. A Roux-en-Y does this by creating a new passageway from which bile can drain directly from your liver or remnant ducts to your small intestines.

If a Roux-en-Y is part of your recovery plan, it is important to appreciate and discuss with your doctor the long term ramifications of the procedure. Most Roux-en-Y patients require regular monitoring to make sure that the Roux-en-Y and ducts do not stricture, i.e., tighten and close, preventing the free flow of bile. Your doctor will likely elect to perform a liver function test as the first step in identifying a stricture. If your numbers are elevated, other diagnostic exams may be performed including additional blood work and a magnetic resonance cholangiopancreatography (or MRCP), which allows the doctor to obtain a non-invasive view of the biliary system.

If strictures develop, there are various procedures that may be performed to reopen the Roux-en-Y connection, including an endoscopic retrograde cholangiopancreatography (or ERCP), a procedure which combines upper gastrointestinal endoscopy and x-rays to treat problems of the bile and pancreatic ducts. During the ERCP, the doctor may try to introduce a thin tube into the obstructed duct (i.e,, cannulate the duct), place a stent in the dilating duct, or even perform a balloon angioplasty to open any closed ducts. If the strictures are reoccurring, treatment may be significant and ongoing for the rest of the patient’s life.

Since a Roux-en-Y procedure usually involves long-term follow-up monitoring or care, patients who require a Roux-en-Y after a laparoscopic cholecystectomy often suffer significant future pain and suffering and medical expenses that should be considered as part of any medical malpractice laparoscopic cholecystectomy action, even when the strictures have yet to develop. It is also important to find an attorney who understands the science and medicine behind these types of injuries and has the resources to fully litigate your claims, including access to expert physicians who can explain to a jury both the malpractice committed by the surgeon performing your laparoscopic cholecystectomy and the short and long term medical care required to address the issues created during the initial surgery.

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