TRENDS IN RESIDENT EXPERIENCE IN OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy (O C) as the most common operation for gallbladder disease. Our goal was to determine the effect of this phenomenon on resident training in bil iary surgery. The numbers of all cholecystectomies (ACs), OCs, LCs, an d advanced procedures (common bile duct exploration and choledochoscop y, (CEDE) performed by residents during academic years 1989 to 1994 we re examined. Trends for the residency as a whole and for each cohort o f residents completing the program were studied. The number of LCs per formed by the residency as a whole per academic year over the 1989 to 1994 period has increased, whereas the number of OCs decreased. The ne t effect of these trends was an increase in the number of ACs. Althoug h the percentage of LCs performed by postgraduate year 1, 2, and 3 res idents (juniors) increased over the study period, the proportion of OC s and ACs performed by this group decreased. For each cohort of reside nts completing training in the years 1989 through 1994, the number of ACs and LCs performed increased, whereas the number of OCs decreased. Experience in CEDE for the residency as a whole and for the cohorts wa s stable. In conclusion, experience in ACs and LCs has increased, and experience in OCs has decreased. Also, experience in biliary surgery h as shifted to the senior level.