Common Bile Duct Transections During Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is considered the standard approach to cholecystectomy. However, this approach is associated with an increased rate of biliary duct injury (BDI) over the open approach. This article focuses on the “classic” and most common BDI, which involves a surgeon transecting the common bile duct (CBD) (deliberately but mistakenly, thinking it is the cystic duct) and then transecting the common hepatic duct later in the process of separating the gallbladder from the liver bed. The causes of CBD transection are complex and involve many different features. This article uses NORCAL Group closed claims to illustrate these features and introduce risk management strategies to address them.