Laparoscopic cholecystectomy as a teaching operation: comparison of outcome between residents and attending surgeons in 1,747 patients.
OBJECTIVE
Standardized surgical training is increasingly confronted with the public demand for high quality of surgical care in modern teaching hospitals. The aim of this study was to compare the results of laparoscopic cholecystectomy (LC) performed by resident surgeons (RS) and attending surgeons (AS).


METHODS
In this retrospective review of prospectively collected data 1,747 LC were performed in a community hospital between 1999 and 2009. Seven hundred seventy operations were performed by RS. Parameters analysed included the duration of operation and length of hospital stay, intraoperative complications, 30-day morbidity and mortality.


RESULTS
Duration of operation was 88 (25-245) min for RS vs. 75 (30-190) min by AS (p = 0.001). Elective operations were shorter when performed by AS (70 (30-190) [AS] vs. 85 (25-240) [RS] min, p = 0.001). Length of hospital stay was shorter in patients treated by RS (4 (1-49) days [RS] vs. 5 (1-83) days [AS], p = 0.1). Intraoperative complications showed no differences between the groups (1.0% [RS] vs. 1.3% [AS], p = 0.6), whereas 30-day morbidity was lower in patients treated by RS (3.8% [RS] vs. 6.2% [AS], p = 0.02). Overall mortality was 0.6% and independent of surgical expertise (0.5% [RS] vs. 0.8% [AS], p = 0.5).


CONCLUSIONS
Provided adequate training, supervision and patient selection, surgical residents are able to perform LC with results comparable to those of experienced surgeons.
Department of Surgery, Spital Limmattal, 8952, Schlieren, Switzerland. r.fahrner@web.de
René
R
Fahrner
Matthias
M
Turina
Valentin
V
Neuhaus
Othmar
O
Schöb
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D007431:Intraoperative Complications; D007902:Length of Stay; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D011183:Postoperative Complications; D055815:Young Adult