Abstract
Laparoscopic cholecystectomy is now a method of choice in treating symptomatic cholelithiasis. The aim of this study was to assess an early integration of surgical residents into performing laparoscopic cholecystectomies and the significance of the integration for their training.
Since February 1992 laparoscopic cholecystectomy (LC) has been performed in our institutions. During the 1st year 253 LCs were done by 4 surgeons—2 residents (in postgraduate years 3 and 4) and 2 staff surgeons; the 2nd year the team was extended and 301 LCs were performed. The residents operated on 364 cases (66%); the overall conversion rate was 5.4%; in the group of patients operated by residents (R) it was 3.8%; in the group operated by staff surgeons (SS) it was 8.4%. The complication rates did not exceed literature reports. The overall complication rate was 3.4%, in the “R” group 3.0% and in the “SS” group 4.2%. It may be concluded that surgical residents can perform LC without additional complications after initial experience with the open technique and appropriate hands-on laboratory training period before starting LC. Continuous training in advanced open biliary procedures should be assured for senior surgical residents.
Similar content being viewed by others
References
Cuschieri A (1993) Reflections on surgical training. Surg Endosc 7: 73–74
Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–392
Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and a analysis of 77,604 cases. Am J Surg 165: 9–14
Deziel DJ, Millikan KW, Staren ED, Doolas A, Economou SG (1993) The impact of laparoscopic cholecystectomy on the operative experience of surgical residents. Surg Endosc 7: 17–21
Dubois F, Berthelot G, Levard H (1991) Laparoscopic cholecystectomy: historic perspective and personal experience. Surg Laparosc Endosc 1: 52–57
Fiallo VM, O'Connor FX, Reed WP (1994) Preceptored introduction of laparoscopic techniques for cholecystectomy into a large university-affiliated medical center. Surg Endosc 8: 1063–1066
Herbs CA, Elliott L, Koruda M, Maxwell JG (1993) Laparoscopic cholecystectomy: comparison of university and community experience. Surg Laparosc Endosc 3: 95–99
Scott-Conner CEH, Hall TJ, Anglin BL, Muakkassa FF, Poole GV, Thompson AR, Wilton PB (1994) The integration of laparoscopy into a surgical residency and implications for the training environment. Surg Endosc 8: 1054–1057
Scott-Coombes D, Thompson JN (1991) Bile duct stones and laparoscopic cholecystectomy. BMJ 303: 281–282
Society of American Gastrointestinal Endoscopic Surgeons (1991) Granting of privileges for laparoscopic general surgery. Am J Surg 161: 324–325
Zucker KA, Bailey RW (1993) Laparoscopic cholangiography and management of choledocholithiasis. In: Zucker KA, Bailey RW, Reddick EJ (eds) Surgical laparoscopy update. Quality Medical Publishing, St. Louis, pp 145–193
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Šefr, R., Ochmann, J. Our experience with early integration of laparoscopic cholecystectomy in surgical residency training. Surg Endosc 9, 902–904 (1995). https://doi.org/10.1007/BF00768888
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00768888