LAPAROSCOPIC CHOLECYSTECTOMY - WHATS SO SPECIAL

One hundred seventy-one laparoscopic cholecystectomies were done by se nior surgery residents who received only traditional ''hands-on'' trai ning. Eight patients (5%) required conversion to open cholecystectomy, and two had complications requiring immediate celiotomy (one common b ile duct injury, one ''dropped'' gallbladder). The average operative t ime was 91 minutes (range, 30 to 245 minutes). There were no deaths an d only five postoperative complications related to the procedure (reta ined common bile duct stone in four cases, intra-abdominal hemorrhage in one). There were three complications unrelated to the procedure. Da ta acquired from recent resident training program graduates show that these practicing surgeons are doing laparoscopic cholecystectomy with a 95% success rate and have yet to encounter appreciable complications . We concluded that a large-volume general surgery resident training p rogram provides adequate opportunity for training surgeons in the tech niques of laparoscopic cholecystectomy; there is no need to attend an expensive and time-consuming classroom and animal laboratory course.