Surgical trainees' attitudes to laparoscopic cholecystectomy: A regional survey

Background and Study Aims: Since the introduction of laparoscopic cholecyst ectomy (LC), numerous articles have been written emphasising its many advan tages over open cholecystectomy (OC). However, reports also highlight incre ased complications following LC such as bile-duct, vascular and bowel injur ies. We aimed to study surgical trainees as a defined population of individ uals who, with increasing exposure to cholecystectomy, would become fully a ware of LC's advantages and controversies. We wished to test the hypothesis that, with increasing in-depth knowledge, they might opt for OC rather tha n LC if they themselves required cholecystectomy. Materials and Methods: We conducted a postal survey of all 133 Northern Ire land surgical trainees identified as having exposure to LC during their tra ining. Trainees were asked whether they would undergo LC and if so with whi ch preconditions. Similarly, if they stated a preference for open cholecyst ectomy they were asked to state the reason. A minimum time period of 18 mon ths was considered adequate for trainees to become relatively more experien ced with their more junior counterparts. Results: A response rate of 80.5% (107/133) was achieved. A total of 51 of 107 trainees had at least 18 months' experience, Of the 107 who replied, 88 .8% (95/107) would be willing to undergo LC. A total of 12 of 107 trainees would opt for OC, with twice as many experienced trainees (8 vs. 4) opting for this approach (n.s. [not significant]), Significantly more experienced trainees cited the use of laparoscopic cholangiography as a precondition fo r LC compared with their inexperienced counterparts (7 vs. 1, p = 0.020). O f 107 trainees, 19 would request use of the open first port (Hasson) techni que; 14 of these had at least 18 months' experience (p = 0.009). Conclusion : Our survey confirms that the majority of trainees would be willing to und ergo LC. However, increased experience of LC may alter an individual's expe ctations about how LC should ideally be performed.