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Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents

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A Correction to this article was published on 16 February 2023

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Abstract

Purpose

This retrospective multicenter cohort study aimed to evaluate the clinical outcomes (mortality rate, operative time, complications) of elective laparoscopic cholecystectomy (LC) when performed by a surgical resident in comparison to experienced consultant in the backdrop of Italian academic centers.

Methods

Retrospective review of all patients undergoing elective LC between January 2016 and January 2022 at six teaching hospitals across Italy was performed. Cases were identified using the Current Procedural Terminology (CPT) code 5123 (LC without cholangiogram). All cases of emergency surgery, ASA score > 3, or when cholecystectomy was performed with another surgical procedure, were excluded. All suitable cases were divided into 2 groups based on primary surgeon: consultant or senior resident. Main outcome was complication rates (intraoperative and peri/postoperative); secondary outcomes included operative time, the length of stay, and the rate of conversion to open.

Results

A total of 2331 cases (1425 females) were included, of which, consultants performed 1683 LCs (72%), while the residents performed 648 (28%) surgeries. The groups were statistically comparable regarding demographics, history of previous abdominal surgery, operative time, or intraoperative complications. The rate of conversion to open cholecystectomy was 1.42% for consultant and none for resident (p = 0.02). A statistically significant difference was observed between groups regarding the average length of stay (2.2 ± 3 vs 1.6 ± 1.3 days p = 0.03). Similarly, postoperative complications (1.7% vs 0.5%) resulted in statistically significant (p = 0.02) favoring resident group.

Conclusions

Our study demonstrates that in selected patients, senior residents can safely perform LC when supervised by senior staff surgeons.

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Authors and Affiliations

  1. Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, ‘La Sapienza, Latina, Italy

    Angelo Iossa, Alessandra Micalizzi, Mary Giuffrè, Maria Chiara Ciccioriccio, Pietro Termine, Francesco De Angelis & Cristian Eugeniu Boru

  2. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Giuseppe Di Buono & Antonino Agrusa

  3. Department of Surgical Sciences, University of Turin, Citta della Salute e della Scienza Hospital, Turin, Italy

    Antonio Salzano & Mario Morino

  4. Department of Morphology, Surgery and Experimental Medicine, Sant’Anna University Hospital, University of Ferrara, Ferrara, Italy

    Matteo Chiozza & Gabriele Anania

  5. Department of Digestive Surgery, Careggi University Hospital, Florence, Italy

    Carlotta Agostini & Francesco Coratti

  6. Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy

    Vania Silvestri, Umberto Bracale & Francesco Corcione

  7. Department of Surgery ‘P. Valdoni’, Head-General Surgery Unit, University of Rome, ICOT Hospital, La Sapienza’, Latina, Italy

    Giuseppe Cavallaro

  8. Department of Medical-Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy

    Gianfranco Silecchia

Authors
  1. Angelo Iossa
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  2. Alessandra Micalizzi
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  4. Maria Chiara Ciccioriccio
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  5. Pietro Termine
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  6. Francesco De Angelis
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  7. Cristian Eugeniu Boru
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  8. Giuseppe Di Buono
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  19. Mario Morino
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  20. Gianfranco Silecchia
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Contributions

A.I.: designed the study, data collection, established group connection, manuscript writing, and data analysis.

M.G., A.M., M.C.C., P.T., F.D.A., C.E.B.: data collection, data analysis.

G.D.B., A.S., M.C., C.A., V.S., A.A., G.A., U.B., F.C., G.C., F.C., M.M.: data collection, critical analysis of the results.

G.S.: Supervisor, data analysis, final revision of the manuscript.

Corresponding author

Correspondence to Angelo Iossa.

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Iossa, A., Micalizzi, A., Giuffrè, M. et al. Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents. Langenbecks Arch Surg 408, 3 (2023). https://doi.org/10.1007/s00423-022-02738-8

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