It would be inappropriate to respond to details of the case as patient confidentiality must be maintained however, some generic points may be made. It is understandable that the family of a deceased patient are distresse

It would be inappropriate to respond to details of the case as patient confidentiality must be maintained however, some generic points may be made. It is understandable that the family of a deceased patient are distressed and disappointed, however, bear in mind that the patient had a cancer which would have been fatal if not operated upon and this kind of complex hepatobiliary surgery is performed in very few centers. Our outcomes with such surgery have been good and I saw no reason to alarm the family unduly about the likely outcome. The sudden deterioration after surgery was unexpected but any major surgery does carry some risk. The estimated cost of the hospital stay is based on a normal recovery. Certainly a patient who remains in the ICU on life support for two weeks will incur higher costs. Unfortunately the nature of this forum is such that patients with a grievance will be motivated to post while those with uneventful recoveries would not.