Background: Resident education in laparoscopic cholecystectomy (LC) wa
s studied in a retrospective analysis of consecutive cases performed a
t two academic institutions with different educational approaches. Met
hods: Each procedure was performed by a resident as operating surgeon
under the direct guidance of one of a small, constant group of LC-cert
ified attendings acting as first assistant. In group I (n = 48), resid
ents acquired LC skills by graded exposure and surgical responsibility
similar to their training in other general surgical procedures. In gr
oup II (n = 48) residents were additionally certified via an intensive
course (including didactic and animal model experience) prior to assu
ming responsibility as surgeon. Results: Results were similar in each
group. No technical errors were identified. Blood transfusion was not
required related to surgery. Conversion to an open procedure occurred
in 10% and 8% in groups I and II, respectively. The rate of complicati
ons was 4% for group I and 8% for group II, A longer operating time wa
s noted in group I and may be attributed to nonoperative reasons. Conc
lusions: Education in LC via graded experience throughout residency ac
hieves results similar to that found with the addition of an intensive
course. This additional training may not be necessary for surgical re
sidents.