title: Less Surgical Experience Has no Impact on Mortality and Morbidity After Laparoscopic Cholecystectomy: A Prospective Cohort Analysis.
abstract: BACKGROUND
  The number of cholecystectomies required to be fully educated as a surgeon has not yet been established. The European Association for Endoscopic Surgery, however, claims that inadequate experience is a risk factor for bile duct injury. The objective was to investigate surgical experience as a risk factor after laparoscopic cholecystectomy.
  
  
  METHODS
  A prospective cohort study using the Danish Cholecystectomy Database to generate a cohort including adults treated with laparoscopic cholecystectomy from 2006 to 2011. The relationship between surgeons' level of experience and outcomes were evaluated.
  
  
  RESULTS
  Surgical inexperience was not a risk factor for mortality and morbidity. The risk of conversion was however higher when the patients were operated by more experienced surgeons with an odds ratio of 1.80 (95% confidence interval, 1.51-2.14). Surgical inexperience was not a risk factor for bile duct injury.
  
  
  CONCLUSIONS
  We found that low surgical experience did not by itself increase the risk of mortality or morbidity.
authors.affiliation: *Department of Surgery, Center for Perioperative Optimization, Herlev Hospital †Department of Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Josephine P
authors.initials: JP
authors.lastname: Rothman
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.forename: Linda
authors.initials: L
authors.lastname: Bardram
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000401:mortality*; D002983:Clinical Competence; D003718:Denmark; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult