IMPACT OF LAPAROSCOPIC CHOLECYSTECTOMY ON SURGICAL TRAINING

All cholecystectomies in a single health district were studied during a 5-year period spanning the introduction of laparoscopic cholecystect omy (LC). The number of LCs increased from 2 (1.3%) in year 3 to 86 (5 6%) in year 5. The number of operative cholangiograms and explorations of the common bile duct performed both fell substantially. The age di stribution did not change significantly during the study period, but t he percentage of females undergoing cholecystectomy increased. The per centage of trainee operations remained constant in those Firms perform ing only open cholecystectomy (OC), but fell from 67% to 9% in those a dopting LC. An increase in annual cholecystectomy rate was seen with t he laparoscopic surgeons, with a corresponding fall for those surgeons performing only OC. There was a threefold increase in the percentage of operations performed privately from years 2 to 5, with 73% being la paroscopic in year 5. The consequences for training of the introductio n of LC must be addressed.