Different perception of surgical risks between physicians and patients undergoing laparoscopic cholecystectomy

Background: Data on the quality of communication during informed consent for surgery is sparse; we investigated this issue in a cohort of patients undergoing laparoscopic cholecystectomy (LC). Methods: Two hundred and seven consecutive patients with benign biliary disease who had undergone LC completed 2 questionnaires. We investigated the patient choice to undergo the surgical procedure along with perceptions of risk complications presented by the surgeon. Nineteen attending surgeons also completed a questionnaire giving information on their recall perception on the information they provided. Multiple logistic regression analyses determined the predictors of perceived communication factors during the informed consent process. Results: One hundred eighty-one patients (87.4%) returned questionnaires. Younger patients (< 50y) with lower education perceived higher level of risk complications compared with older and higher educated patients (P = 0.04 and P < 0.001). Younger patients felt psychologic support was necessary (P < 0.001) and that quality of life issues related to the interventions were under addressed (P = 0.018). Differences were observed between patients' recalled risk of complications and the risk to convert LC to open laparotomy and physicians' perception of information provided to patients regarding these aspects (P < 0.01). Conclusion: Although informed consent for surgical procedures requires that the procedures are explained and that the patient understands the procedures and risks, our data suggest different perceptions of the quality of information provided during this process between patients and physicians. Physicians should be aware that surgical risks might be perceived differently by patients and this perception might be influenced, for example, by patients' age and education. Major efforts should be directed to improve communications skills in surgical laparoscopy.