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Surgical Endoscopy

, Volume 24, Issue 9, pp 2206–2209 | Cite as

Laparoscopic cholecystectomy for acute cholecystitis should be performed by a laparoscopic surgeon

  • Kirsten Kortram
  • Jan Siert Kayitsinga Reinders
  • Bert van Ramshorst
  • Marinus J. Wiezer
  • Peter M. N. Y. H. Go
  • Djamila Boerma
Article

Abstract

Background

The aim of this study was to evaluate the impact of surgical subspecialization on the outcome of laparoscopic cholecystectomy.

Methods

The retrospective cohort study included all consecutive patients who underwent laparoscopic cholecystectomy between June 2002 and June 2009 in a major teaching hospital. Patients were divided into two groups: those operated on by laparoscopy-oriented surgeons (more than 50 laparoscopic procedures annually) and those operated on by nonlaparoscopy surgeons. Surgeries were divided into two groups as well: elective surgery for cholelithiasis and emergency surgery for acute cholecystitis. Conversion rate, operating time, complications, and length of hospital stay were analyzed and compared between both groups.

Results

During the study period 1509 patients underwent laparoscopic cholecystectomy for symptomatic gallstone disease. A laparoscopic surgeon performed the procedure on 893 patients, and 616 patients were operated on by nonlaparoscopy surgeons. For elective surgeries the laparoscopic interest of the surgeon had no influence on the outcome of the procedure. In patients with acute cholecystitis, a significant difference in conversion rate (3.6 vs. 15.6%, p = 0.003) and operating time (68 vs. 76 min, p = 0.02) favored the laparoscopic surgeons.

Conclusions

Patients who present with acute cholecystitis have a greater chance of a laparoscopically completed cholecystectomy if operated on by a laparoscopy-oriented surgeon.

Keywords

Cholecystectomy Laparoscopic Cholecystitis Conversion GI Subspecialization 

Notes

Disclosures

Drs. Kortram, Reinders, van Ramshorst, Wiezer, Go, and Boerma have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Boerma D, Rauws EA, Keulemans YC, Bergman JJ, Obertop H, Huibregtse K, Gouma DJ (2001) Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis. Ann Surg 234:750–757CrossRefPubMedGoogle Scholar
  2. 2.
    de Reuver PR, Sprangers MA, Gouma DJ (2007) Quality of life in bile duct injury patients. Ann Surg 246:161–163CrossRefPubMedGoogle Scholar
  3. 3.
    Hasukic S, Mesic D, Dizdarevic E, Keser D, Hadziselimovic S, Bazardzanovic M (2002) Pulmonary function after laparoscopic and open cholecystectomy. Surg Endosc 16:163–165CrossRefPubMedGoogle Scholar
  4. 4.
    Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D (1994) Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Br J Surg 81:1362–1365CrossRefPubMedGoogle Scholar
  5. 5.
    Livingston EH, Rege RV (2004) A nationwide study of conversion from laparoscopic to open cholecystectomy. Am J Surg 188:205–211CrossRefPubMedGoogle Scholar
  6. 6.
    Hendolin HI, Paakonen ME, Alhava EM, Tarvainen R, Kemppinen T, Lahtinen P (2000) Laparoscopic or open cholecystectomy: a prospective randomised trial to compare postoperative pain, pulmonary function, and stress response. Eur J Surg 166:394–399CrossRefPubMedGoogle Scholar
  7. 7.
    Boddy AP, Bennett JM, Ranka S, Rhodes M (2007) Who should perform laparoscopic cholecystectomy? A 10-year audit. Surg Endosc 21:1492–1497CrossRefPubMedGoogle Scholar
  8. 8.
    Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev (4):CD006229Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Kirsten Kortram
    • 1
  • Jan Siert Kayitsinga Reinders
    • 1
  • Bert van Ramshorst
    • 1
  • Marinus J. Wiezer
    • 1
  • Peter M. N. Y. H. Go
    • 1
  • Djamila Boerma
    • 1
  1. 1.Department of SurgerySt. Antonius HospitalNieuwegeinThe Netherlands

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