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Patients support transfer of care for unexpected findings in laparoscopic cholecystectomy

  • Shanley B. DealEmail author
  • Jennifer A. Rich
  • Elizabeth Carlson
  • Guillaume S. Chevrollier
  • Michael J. Pucci
  • Adnan A. Alseidi
Article
  • 29 Downloads

Abstract

Introduction

Surgeons often assume patients may be dissatisfied if their operations were stopped due to suspicious intraoperative findings requiring transfer of care. We sought to assess patient opinions regarding transfer of care for unexpected intraoperative findings during laparoscopic cholecystectomy with and without bile duct injury (BDI).

Methods and procedures

The investigators developed two clinical scenarios comparing transfer of care for unexpected intraoperative findings during elective laparoscopic cholecystectomy: without BDI and with BDI requiring open repair. A multi-institutional structured telephone interview process was conducted with patients ≥ 18 years of age who had an outpatient, uncomplicated laparoscopic cholecystectomy within the last year. The first scenario presented a case of suspicious findings prompting the surgeon to stop and transfer for specialized care; whereas the second case was a BDI requiring transfer of care. Textual and thematic analysis as well as descriptive statistics was used for analysis, with significance set at p < 0.05.

Results

Forty-five patients completed the survey. Satisfaction with transfer of care for unexpected intraoperative findings without BDI was 69%, and over 95% of respondents were satisfied their surgeon stopped the procedure to initiate transfer due to safety concerns; 64% of patients would return to that surgeon for postoperative care; and 78% would see that surgeon again. In the scenario with BDI requiring open repair, 86% were satisfied with their surgeon’s decision to stop the operation; 91% of patients were satisfied with transfer of care; and 32% would see their first surgeon again. Themes of prioritizing safety and transparency were frequently cited.

Conclusions

Patients prioritize safety and are satisfied with halting a procedure to facilitate transfer of care for suspicious intraoperative findings during routine laparoscopic cholecystectomy.

Keywords

Laparoscopic cholecystectomy Patient-centered care Bile duct injury Patient perceptions Transfer of care 

Notes

Compliance with ethical standards

Disclosures

The authors, Shanley Deal, Jessica Rich, Elizabeth Carlson, Guillaume Chevrollier, Michael Pucci, and Adnan Alseidi, have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Virginia Mason Medical Center, General, Thoracic and Vascular SurgerySeattleUSA
  2. 2.Sidney Kimmel Medical College of Thomas Jefferson UniversityPhiladelphiaUSA

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