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Biomedical subjects

K E Wheatley

Publications and source records attributed to K E Wheatley.

5 recordsLinked to original sources

Consent and complications: risk disclosure varies widely between individual surgeons.

AIMS: To assess variations in consent practice for a single operative procedure, namely laparoscopic cholecystectomy, particularly with respect to the frequency with which potential complications are discussed with patients. METHODS: Postal questionnaire sent to general surgeons in the West Midlands and to UK members of the Association of Endoscopic Surgeons of Great Britain and Ireland. Respondents were asked to estimate how often they discussed particular complications with their patients pre-operatively. RESULTS: Conversion to open cholecystectomy was the most frequently discussed complication. Other complications were much less likely to be mentioned overall and there was disturbing variation between individual surgeons in the frequency with which certain complications were discussed, particularly the risk of bile duct injury. CONCLUSIONS: In order for consent to be informed, patients need to be aware of significant risks. Our results indicate a lack of consensus from surgeons as to which risks are significant for this operation and this is likely to be true for other procedures.

Cholecystectomy, Laparoscopic↗

Acute haemorrhage from gastric malignancy.

The presentation, pathology and treatment of 30 patients with acute bleeding from gastric malignancies has been reviewed. Patients usually have a history of symptoms of less than 6 months prior to bleeding. Adenocarcinoma was the commonest type of tumour, and 74 per cent were stage IV lesions. The proportion of lesions in the body of the stomach (57 per cent) was greater than expected, suggesting that these are different populations of gastric tumour. Laparotomy was undertaken in 20 patients, 12 of whom had a resection. Resection was associated with a median survival of 17.0 months. Those with unresectable tumours or who were treated only by supportive measures had a median survival of only 2.5 months (P less than 0.01). Evidence of peritoneal or liver involvement should contraindicate surgical intervention as these patients have a high postoperative mortality rate.

Acute Disease↗