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Related Experiment Videos

Informed consent and choice in cholecystectomy.

Mark D Stringer1

  • 1Children's Liver Unit, Gledhow Wing, St James's University Hospital, Leeds LS9 7TF, UK. mdstringer@dial.pipex.com

Pediatric Surgery International
|October 19, 2004
PubMed
Summary

Informed parents of children undergoing cholecystectomy often choose mini-cholecystectomy (MC) over laparoscopic cholecystectomy (LC) when risks and benefits are fully explained, indicating a preference for less invasive options.

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Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Informed Consent

Background:

  • Informed consent is crucial in pediatric surgery due to increasing patient/parental information seeking and litigation risks.
  • Laparoscopic cholecystectomy (LC) in adults has a slightly higher risk of bile duct injury compared to open procedures, a risk not yet documented in pediatric practice.
  • Cholecystectomy is relatively uncommon in children.

Purpose of the Study:

  • To investigate parental and patient choices between laparoscopic cholecystectomy (LC) and mini-cholecystectomy (MC) when fully informed.
  • To assess the decision-making process in pediatric cholecystectomy when specific indications for open or laparoscopic techniques are absent.

Main Methods:

  • A review of 57 consecutive pediatric cholecystectomy cases.
Keywords:
Empirical ApproachProfessional Patient Relationship

Related Experiment Videos

  • Patients were categorized into those with specific indications for open or LC procedures and those counseled on LC vs. mini-cholecystectomy (MC) for elective choice.
  • Counseling detailed cosmetic, comfort, and recovery benefits of LC versus the potential for increased bile duct injury risk in adults, with MC performed via a 4-cm incision.

    • Main Results:

    • Of 35 children with no specific indications, 23 parents chose LC and 12 chose MC.
    • No surgical complications or conversions occurred in either group.
    • LC patients had a slightly shorter mean hospital stay (1.7 days) compared to MC patients (2.3 days), though not statistically significant (p > 0.05).

    Conclusions:

    • When fully informed about risks and benefits, a significant minority of parents/patients opt for mini-cholecystectomy (MC) in pediatric cholecystectomy when neither LC nor open surgery is specifically indicated.
    • This suggests that patient preference plays a role in surgical technique selection beyond purely clinical indications.
    • Further research is warranted to understand long-term outcomes and patient satisfaction with different cholecystectomy approaches in pediatric populations.