Liver Surgery Consent Form

Mark Fraiman, M.D.
Richard Mackey Jr., M.D.
Liver Surgery Consent Form
Hepatic resection or removal of a portion of one’s liver is a complex intraabdominal
operation that requires the skill of a highly-specialized surgeon. The procedure
is typically performed in an open fashion through a generous incision or on occasion
using minimally invasive techniques if deemed appropriate by the surgical team. The
procedure can take anywhere from 2-5 hours to perform. Because the liver is a highly
vascular organ, blood transfusions are required on occasion. A tube will be exiting your
abdominal wall following surgery which is usually removed prior to discharge. You will
also have a tube in your nose to decompress your stomach for one to two days.
The material risks and complications more specific to liver surgery include
leakage from the biliary system, either from the cut edge of the liver or from the common
bile duct. If a large portion of the liver needs to be removed, there is a chance of
developing liver insufficiency or failure. Because the liver is an organ with a regenerative
capacity, liver insufficiency will frequently resolve with supportive care. Patients who
have received pre-operative chemotherapy will however be at higher risk secondary to
impairment in liver regeneration.
Other more general complications that may occur with any intra- abdominal
operation include but are not limited to infections (wound, urinary tract, or intraabdominal),
pneumonia, pulmonary embolism, deep venous thrombosis, myocardial
infarction or other cardiac events, or infrequently death. The morbidity or chance of
complication from liver surgery is about 30%, and the mortality or chance of death is on
the order of 3-5%.
Alternative options to surgical therapy were discussed in the office.
It is the surgeon’s expectations that you comply with the use of incentive
spirometry and early ambulation in the post-operative period.
An opportunity to answer all your questions was given to you during your preoperative
visit.
I have read the above consent form and consent to the liver surgery as scheduled.
_____________________ patient’s signature
_____________ Date

_______________________ witness
___________ date
_______________________ surgeon’s signature
___________ date