Safety of Laparoscopic Cholecistectomy performed by Residents

Introduction: Laparoscopic cholecistectomy is becoming widely performed by Italian surgical residents, but specific outcomes have been poorly investigated, as compared to those carried out by experienced surgeons. Methods: Data from 188 consecutive, unselected patients who underwent LC performed by residents between 2000 and 2006 at our institution were collected. An equal number of LC performed over the same period by experienced surgeons were randomly extracted from the database. Demographics, periopeoperative parameters and complications were matched among the two groups. Results: Age, gender, ASA score, length of stay, proportion of urgent operation and cholecystitis were all well matched in the two groups. No major complications were collected in both series. The number of IOC, rendez-vous, drainages, and minor complications were also equal. Nevertheless, the overall conversion rate and the mean difficulty score (0–20) were lower among residents (1 vs. 5%, p 0.03 and 6.65 vs. 7.32, p 0.04 respectively). On the other hand, the mean duration of surgery was significantly longer in the residents group (71 vs. 62 minutes, p 0.000). Discussion: Italian residents have fewer possibilities to gain sufficient skills at the end of their residentship, as compared to their foreign colleagues due to social, cultural, political and academic troubles. However, LC is a safe and common procedure even in the hands of Italian trainees, although patients’ selection is strictly required. In fact, tthis study found that residents performed less complex operations in more time, as compared to senior surgeons.