Julian Maendel, MD, William Hope, MD, Thomas Clancy, MD. New Hanover Regional Medical Center
Objective: To evaluate the role of routine intraoperative cholangiography in a surgical residency program, and whether level of training correlates with technical proficiency and length of procedure.
Design: We retrospectively reviewed all patients undergoing laparoscopic cholecystectomy with intraoperative cholangiography by surgical residents (PGY 1-5) under the supervision of a single attending surgeon from April 2010 to October 2015. Cholangiogram duration and success rates, patient demographics, resident training level, procedural indications, and operative information were recorded, and factors associated with increased cholangiogram times were compared using ANOVA and X2; a p-value of <0.05 was considered significant.
Setting: Academic-affiliated community-based surgical residency program
Participants: 24 surgical residents, PGY 1-5.
Results: Laparoscopic cholecystectomy with intraoperative cholangiography was performed in 227 patients. The average patient age was 45.5 years; 71.7% were Caucasian and 70.4% were female. Cholangiography was successful in 96% of patients. The average time for cholangiograms performed by residents was 9 minutes (range, 7-24 minutes). Minor technical complications related to cholangiograms occurred in 32% of cases, with the most common being difficulty with clipping the catheter (20%). There was a significant decrease in both cholangiogram time and need for attending assistance after the PGY-1 year, even when adjusted for individual residents (p>0.05).
Conclusions: The routine use of intraoperative cholangiography in a general surgery teaching program results in increased technical proficiency and decreased operative time after the PGY-1 year, and can be safely performed by residents at every level without adding significant time to the operation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80605
Program Number: P097
Presentation Session: Poster (Non CME)
Presentation Type: Poster