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Impact on laboratory training in subsequent performance of laparoscopic cholecystectomy
Toshihiko Shinohara1, Tetsuji Fujita, Takeyuki Misawa
1Department of Surgery, The Jikei University School of Medicine, Nishi-shinbashi, 3-25-8, Minato-ku, Tokyo, 105-8461, Japan. shinohara@jikei.ac.jp
Background:
The purpose of this study was to evaluate the long-lasting influence of laparoscopic training during residency course on outcomes of laparoscopic cholecystectomy (LC).
Materials And Methods:
We compared outcomes of LC in patients treated by surgeons who have learned LC by the traditional surgical residency program (traditional group; n = 15) with those of LC operated on by surgeons who received additional intensive laboratory training in their residency [Jikei Surgical Skill Training Program (JSTP) group; n = 9].
Results:
Among the 503 patients subjected to LC, 302 (60.0%) cases were performed by surgeons in the traditional group and 201 (40.0%) cases in the JSTP group. The patient characteristics, operative outcome variables, and the pathological findings of the gallbladder were comparable in the two groups. Despite no difference in the above factors, conversion rates were significantly higher in the traditional group compared with the JSTP group (10.6% vs 5.0%; p = 0.026). In multivariate analysis, training background was an independent risk factor for conversion to open surgery (odds ratio, 2.79; 95% confidence interval, 1.25-6.24).
Conclusions:
To ensure competence for laparoscopic skills, we propose that such training program should be integrated into the curriculum of the general surgery residency.
