BACKGROUND: Around 50,000 laparoscopic cholecystectomies (LC) are undertaken annually in the UK making it the most commonly performed elective intra-abdominal operation. In 2006/2007, litigation claims cost the NHS (National Health Service) over 600 million GBP (940 million USD). Despite surgical specialties accounting for the greatest number of claims over the last decade, no data has been published on litigation following LC in the UK. In this study, we looked at trends in litigation following LC over the last decade in an attempt to improve patient care.METHODS: Data from the NHS Litigation Authority on claims following LC between 1995-2007 were obtained and analysed.RESULTS: 379 claims were made of which 299 had been settled. 198 (66%) were successful resulting in a total cost of 20.4 million GBP (32 million USD) to the NHS. Operator error was the most likely cause to result in a claim and the only cause associated with a successful claim (p=0.041). Bile duct injury (BDI) was the most frequent injury resulting in litigation and the most likely injury associated with a successful claim (p<0.001). Vascular and visceral injuries were involved in relatively few claims, but when involved, were associated with a high rate of success. Vascular injury resulted in the highest average payout of 124,000 GBP (190,000 USD) (Figure).CONCLUSION: Operator error, leading primarily to BDI was the commonest cause of litigation and the only injury that predicted a successful claim. Approaches that can minimise bile duct injury should be adopted to minimise the litigation burden and improve patient care.