title: Consenting practice for laparoscopic cholecystectomy - are we doing enough to warn patients about their operation?
abstract: BACKGROUND
  Provision 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.
  
  
  METHODS
  Retrospective review of medical notes of all patients undergoing LC at London district general hospital between September 2006 to April 2009.
  
  
  RESULTS
  Records 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.
  
  
  CONCLUSIONS
  Consenting 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.
authors.affiliation: Department of General Surgery, North Middlesex University Hospital, Sterling Way, London N18 1XL, United Kingdom. mohsinuzzaman@yahoo.co.uk
authors.forename: Mohammed Mohsin
authors.initials: MM
authors.lastname: Uzzaman
authors.forename: Salim
authors.initials: S
authors.lastname: Tayeh
authors.forename: Sidhartha
authors.initials: S
authors.lastname: Sinha
authors.forename: Kumaran
authors.initials: K
authors.lastname: Ratnasingham
authors.forename: David L
authors.initials: DL
authors.lastname: Stoker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D032962:Consent Forms / Q000592:standards; D030881:Disclosure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000592:standards*; D008131:London; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult