Nj. Shaper et al., IMPACT OF LAPAROSCOPIC CHOLECYSTECTOMY ON SURGICAL TRAINING, Annals of the Royal College of Surgeons of England, 78(1), 1996, pp. 39-42
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.