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How to learn the laparoscopic cholecystectomy (LC)? : A learning curve of one surgical resident for initial 151 cases

Yun Kyung Jung, Dongho Choi, Hwon Kyum Park, Kyeong Geun Lee. College of Medicine, Hanyang University

Introduction: Laparoscopic cholecystectomy (LC) has been widely performed for the treatment of gallbladder disease. However, it has potential fatal complications like bile duct injury which are correlated with inexperience. Therefore, surgical training for safe and exact LC technique is important for surgical residents. The aim of this study is to investigate the personal learning curve of one resident and confirm the safety of LC performed by surgical residents.

Methods: We retrospectively reviewed 151 patients who underwent LC by one surgical resident at the Hanyang University Hospital. Three or four trocars were inserted and we established the “critical view of safety” in all patients. All procedures were supervised by an experienced HBP surgeon.

Results: Of total 428 LCs during the study, 151 cases were performed by one surgical resident. There were no statistical differences between two groups (group 1 – experienced surgeon, and group 2 – surgical resident) in open conversion rate (3.2% vs 0.7%, p=0.106) and postoperative complications (3.3% vs 6.6%, p=0.107). No major complications including bile duct injury were recorded in both groups. There was significant difference between two groups in operative time (51.52 vs 62.48, p<0.001).

Conclusion: LC performed by surgical residents is safe although they operated with longer operative time. However, inexperience surgeons must always keep in mind confirmation of CVS and basic laparoscopic surgery technique during LC. These principles should be trained by attending staff for learning curve period.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87692

Program Number: P114

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

220

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