Finding into death of Kenneth James Anderson

85y · Male·Liver ischaemia and portal vein thrombosis complicating emergency cholecystectomy secondary to acute cholecystitis

Kenneth James Anderson, an 85-year-old man with intellectual disability and multiple comorbidities including diabetes, pancreatitis, and gallstones, died following emergency cholecystectomy for acute cholecystitis with Mirizzi's syndrome. Intraoperative complications included major bile duct injury, right hepatic artery transection, and portal vein occlusion—all iatrogenic injuries from difficult dissection in inflamed tissue. Despite appropriate management of complications, the patient developed liver ischaemia and portal vein thrombosis, leading to multi-organ failure. The coroner found no want of care: surgery was necessary (patient would have died of sepsis), consent was appropriate, preoperative imaging was standard, and the extent of Mirizzi's syndrome could only be identified intraoperatively. Surgeons responded appropriately to unexpected complications. The death was an accepted surgical risk in a high-risk patient.