Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?
OBJECTIVE
To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure.


METHODS
Prospectively documented series, retrospective analysis.


METHODS
University teaching hospital, Austria.


METHODS
581 consecutive patients who underwent elective LC for symptomatic cholelithiasis between January 1993 and December 1997.


METHODS
LC were allocated to three groups: the first (n = 91) were done by supervised beginners (who had done fewer than 11 LC), the second (n = 249) by supervised trainees who had a little experience (they had done more than 10 but fewer than 51 LC), and the third group (n = 241) who were experienced surgeons (they had done more than 50 LC).


METHODS
Minor and major complications, conversion and reoperation rate, length of operation and postoperative hospital stay.


RESULTS
The minor intraoperative complication rates were 36/91 (40%), 115/249 (46%) and 49/241 (20%), respectively (p < 0.001 when experienced surgeons were compared with the 2 trainees' groups). There were no significant differences between the three groups regarding major complications (1/91, 4/249 and 4/241), conversions (5/91, 21/249, and 17/241) and reoperation rate (1/91, 3/249 and 3/241), median (range) length of operation 82 (24-159), 84 (25-249) and 82 (21-234) minutes and hospital stay 4 (3-19), 4 (3-11) and 4 (2-15) days.


CONCLUSIONS
Elective LC for symptomatic cholelithiasis done by trainees under supervision does not increase surgical morbidity.
Imhof
M
M
University Clinic of Surgery, University of Vienna, Vienna General Hospital, Vienna, Austria.
Zacherl
J
J
Rais
A
A
Lipovac
M
M
Jakesz
R
R
Fuegger
R
R
D001317:Austria; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002769:Cholelithiasis / Q000601:surgery; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D006801:Humans; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome