Original researchConsenting practice for laparoscopic cholecystectomy - Are we doing enough to warn patients about their operation?

IntroductionProvision of informed consent prior to surgery is fundamental in allowing patients to make balanced choices about their care. This study compares consenting practice amongst different grade of surgeons for Laparoscopic Cholecystectomy (LC) with specific reference to the documentation of the complications of surgery. Timing and delivery of source of information is also evaluated.MethodsRetrospective review of medical notes of all patients undergoing LC at London district general hospital between September 2006 to April 2009.ResultsRecords were successfully retrieved for 163 patients. The five most commonly mentioned complications were bleeding (99%), infection (95%), conversion to open (93%), bile duct injury (82%) and visceral injury (65%). There were 27 documented complications in 23 patients and in 9 of these patients (39%) the specific complication was not discussed during the written consent process. Consultant surgeons tended to focus on important operation-specific risks such as bile duct injury whereas junior surgeons tend to focus on a broad range of general complications.ConclusionConsenting practice for LC remains variable and is resulting in failure to warn patients of significant complications. This can lead to potential medico-legal implications. Having a structured consent form detailing all significant and common risk is one way of improving the consent process.

► This study compares consenting practice for Laparoscopic Cholecystectomy between September 2006 and April 2009. ► Retrospective review of 163 written consent forms for grade of consentor, timing of consent and complications discussed. ► Consultant surgeons tend to focus on important operation-specific risks such as bile duct injury and bile leak. ► Junior surgeons tend to focus on a broad range of general complications such as infection and thromboembolism. ► Having a structured consent form detailing all significant and common risk is one way of improving the consent process.