Analysis of a structured training programme in laparoscopic cholecystectomy.
BACKGROUND
Laparoscopic cholecystectomy is an established treatment for almost all gallbladder diseases with bile duct injury rates similar to open cholecystectomy. These laparoscopic skills must be passed on to junior surgeons without compromising patient safety.


METHODS
We analysed our structured training programme over 6years (May 2000 to May 2006) by following three trainee surgeons during their training and beyond. During this period, 1,000 laparoscopic cholecystectomies were carried out with five consultant surgeons supervising and three new trainees who completed their accreditation in laparoscopic cholecystectomy.


RESULTS
There were 694 patients operated on by consultant surgeons (Group 1), 202 by trainee surgeons (Group 2) and 104 by newly trained surgeons (Group 3). There were no differences between the groups in terms of age and gender. However, there was a significant difference in gallbladder disease among the three groups; Group 2 had more gallstone pancreatitis patients (P < 0.019). There were no differences among the three groups in conversion rates, bile duct injury rates, general complication rates or length of stay. However, the duration of operation in Group 2 was significantly longer compared to the other two groups (P < 0.0001).


CONCLUSIONS
This programme is effective in training junior surgeons and does not compromise patient safety.
Ibrahim
Salleh
S
Department of General Surgery, Changi General Hospital, Singapore. salleh_ibrahim@cgh.com.sg
Tay
Khoon Hean
KH
Lim
Swee Ho
SH
Ravintharan
T
T
Tan
Ngian Chye
NC
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003253:Consultants; D003479:Curriculum; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D008611:Mentors; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013996:Time and Motion Studies; D006113:United Kingdom