This document provides an informed consent form for a laparoscopic cholecystectomy (LC). It outlines some of the key risks and benefits of the procedure. The risks discussed include: bleeding, infections, bile leak, damage to the bile ducts or other organs, blood clots, stroke, and in rare cases single or multi-organ failure and mortality. Extra procedures that may be required, such as repairing injuries to organs or draining the bile duct, are also outlined. Alternative procedures like partial cholecystectomy or abandoning the surgery are mentioned if the LC cannot be successfully completed.

1. LAPAROSCOPIC CHOLECYSTECTOMY:
INFORMED CONSENT FORM
Raimundas Lunevicius
Consultant Surgeon & Honorary Senior Lecturer
Emergency, Trauma, Biliary, Hernia Surgery
Aintree University Hospital NHS Foundation Trust, Liverpool, England
2018
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2. Consent
• The majority of LC go to
elective patients where
there is plenty of time to
discuss it
• It is very important that
you find time to give
your patient a leaflet and
discuss with them the
risks and benefits of LC
• Extra procedures and
the alternatives available
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3. Risks or
The significant, unavoidable or frequently occurring risks
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4. Bleeding, infections (including wound infection and
pneumonia), bile leak, CBD injury (damage of the bile
ducts), DVT/PE (formation of venous thrombus), CVA
(cardiovascular accident including stroke and myocardial
infarction), damage of other organs (i.e. bowel, stomach,
spleen, etc.), incisional hernia, pain, single or multiorgan
failure, mortality. Others.
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5. The significant, unavoidable or
frequently occurring risks
• Intraoperative: Massive bleeding, injury to the bowel,
stomach, main bile duct or its branches, diaphragm, bile
leakage, spilled / retained / residual gallstones.
Intraoperative disorder of the heart: bradycardia and cardiac arrest.
General anesthetic related risks will be discussed with Anesthetist.
• Postoperative: Collection of fluids, infection (wound,
chest, intraabdominal), PE / DVT, cardiovascular accident,
ischemic stricture or perforation of the bile duct or bowel;
Percutaneus drainage, re-laparoscopy, laparotomy
Postdischarge: postoperative gastritis/diarrhea, incisional hernia
The risk of death due to catastrophic bleeding, multi-organ failure
cardiac event should be discussed with individual patient
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6. Extra procedures
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7. Extra procedures
• Blood Component Transfusion
• Repair of fistulae with bowel.
• Repair of the main bile duct, vessel, diaphragm
• Drainage of the main bile duct
• Exploration of bile duct
• Biliary reconstruction (connection of the MBD to the bowel)
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8. Alternative procedures
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9. Alternative procedures
• Subtotal (partial) cholecystectomy
• Abandoned cholecystectomy
• Cholecystostomy
• Cholecistolithotomy
• Medical advice regarding these alternatives will be given
after surgery
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