Training higher surgical trainees in laparoscopic common bile duct exploration

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Education

Background:

• Laparoscopic common bile duct (CBD) exploration is a preferred method for treating ductal calculi, offering an alternative to endoscopic retrograde cholangiopancreatography.
• This study investigates the efficacy and safety of laparoscopic CBD exploration performed by surgical trainees versus experienced consultants.

Purpose of the Study:

• To compare the outcomes of laparoscopic CBD exploration performed by trainees and experienced consultants.
• To assess success rates, complication profiles, and operative times between the two groups.

Main Methods:

• A retrospective analysis of a prospective database of laparoscopic CBD explorations over 15 years.
• All procedures utilized a four-port technique with intraoperative cholangiography.
• Data on patient demographics, operative details, success, and complications were collected and analyzed.

Main Results:

• A total of 235 laparoscopic CBD explorations were analyzed; 79% by a consultant and 21% by trainees.
• Successful calculi clearance was high in both groups (88% consultant, 96% trainee).
• No significant differences were observed in CBD clearance, surgical approach, or complication rates between consultant and trainee groups, though trainee operating time was longer (p < 0.05).

Conclusions:

• Laparoscopic CBD exploration is a safe and effective procedure when performed by both experienced consultants and surgical trainees.
• Surgical trainees can achieve comparable outcomes to consultants in terms of CBD clearance and complication rates with appropriate training.
• This supports the integration of laparoscopic CBD exploration into surgical training curricula.