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Laparoscopic cholecystectomy: an audit of our training programme
Swee Ho Lim1, Ibrahim Salleh, Beow Kiong Poh
1Department of General Surgery, Changi General Hospital, Singapore. sweeho@singnet.com.sg
ANZ Journal of Surgery
|April 21, 2005
Summary
A structured training program effectively trains junior surgeons in laparoscopic cholecystectomy, ensuring patient safety. Auditing conversion and bile duct injury rates confirms the program's success.
Area of Science:
- Surgical Education
- Minimally Invasive Surgery
- Patient Safety
Background:
- Laparoscopic cholecystectomy has a steep learning curve, posing training challenges for surgical residents.
- Balancing effective surgical training with patient safety is crucial for teaching hospitals.
Purpose of the Study:
- Assess the safety and efficacy of a structured laparoscopic cholecystectomy training program.
- Audit conversion and bile duct injury rates in laparoscopic cholecystectomies.
- Identify factors influencing conversion and bile duct injury rates.
Main Methods:
- Retrospective review and prospective data collection of 443 laparoscopic cholecystectomies over 18 months.
- Analysis of demographics, conversion details, and bile duct injuries.
- Comparison of outcomes between consultant surgeons and registrars trained in the program.
Main Results:
- Overall conversion rate was 11.5%; no significant difference between consultant and registrar groups (P=0.284).
- Male patients had a higher conversion rate (16.6%) than female patients (8.2%) (P=0.007).
- A single bile duct injury occurred, resulting in a rate of 0.23%.
Conclusions:
- A structured training program with close supervision and audit effectively trains junior surgeons in laparoscopic cholecystectomy.
- Patient safety is maintained during surgical training.
- The program demonstrates low conversion and bile duct injury rates.