Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents

Angelo Iossa¹, Alessandra Micalizzi², Mary Giuffrè², Maria Chiara Ciccioriccio², Pietro Termine², Francesco De Angelis², Cristian Eugeniu Boru², Giuseppe Di Buono³, Antonio Salzano⁴, Matteo Chiozza⁵, Carlotta Agostini⁶, Vania Silvestri⁷, Antonino Agrusa³, Gabriele Anania⁵, Umberto Bracale⁷, Francesco Coratti⁶, Giuseppe Cavallaro⁸, Francesco Corcione⁷, Mario Morino⁴, Gianfranco Silecchia⁹

Affiliations

¹ Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy. angelo.iossa@uniroma1.it.
² Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy.
³ Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
⁴ Department of Surgical Sciences, University of Turin, Citta della Salute e della Scienza Hospital, Turin, Italy.
⁵ Department of Morphology, Surgery and Experimental Medicine, Sant'Anna University Hospital, University of Ferrara, Ferrara, Italy.
⁶ Department of Digestive Surgery, Careggi University Hospital, Florence, Italy.
⁷ Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy.
⁸ Department of Surgery 'P. Valdoni', Head-General Surgery Unit, University of Rome, ICOT Hospital, La Sapienza', Latina, Italy.
⁹ Department of Medical-Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy.

PMID: 36577814
DOI: 10.1007/s00423-022-02738-8

Multicenter Study

Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents

Angelo Iossa et al. Langenbecks Arch Surg. 2022.

. 2022 Dec 29;408(1):3.

doi: 10.1007/s00423-022-02738-8.

Authors

Affiliations

¹ Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy. angelo.iossa@uniroma1.it.
² Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy.
³ Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
⁴ Department of Surgical Sciences, University of Turin, Citta della Salute e della Scienza Hospital, Turin, Italy.
⁵ Department of Morphology, Surgery and Experimental Medicine, Sant'Anna University Hospital, University of Ferrara, Ferrara, Italy.
⁶ Department of Digestive Surgery, Careggi University Hospital, Florence, Italy.
⁷ Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy.
⁸ Department of Surgery 'P. Valdoni', Head-General Surgery Unit, University of Rome, ICOT Hospital, La Sapienza', Latina, Italy.
⁹ Department of Medical-Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy.

PMID: 36577814
DOI: 10.1007/s00423-022-02738-8

Erratum in

Correction to: Langenbeck's Archives of Surgery Journal.
[No authors listed] [No authors listed] Langenbecks Arch Surg. 2023 Feb 16;408(1):92. doi: 10.1007/s00423-023-02824-5. Langenbecks Arch Surg. 2023. PMID: 36792843 Free PMC article. No abstract available.

Abstract

Purpose: This retrospective multicenter cohort study aimed to evaluate the clinical outcomes (mortality rate, operative time, complications) of elective laparoscopic cholecystectomy (LC) when performed by a surgical resident in comparison to experienced consultant in the backdrop of Italian academic centers.

Methods: Retrospective review of all patients undergoing elective LC between January 2016 and January 2022 at six teaching hospitals across Italy was performed. Cases were identified using the Current Procedural Terminology (CPT) code 5123 (LC without cholangiogram). All cases of emergency surgery, ASA score > 3, or when cholecystectomy was performed with another surgical procedure, were excluded. All suitable cases were divided into 2 groups based on primary surgeon: consultant or senior resident. Main outcome was complication rates (intraoperative and peri/postoperative); secondary outcomes included operative time, the length of stay, and the rate of conversion to open.

Results: A total of 2331 cases (1425 females) were included, of which, consultants performed 1683 LCs (72%), while the residents performed 648 (28%) surgeries. The groups were statistically comparable regarding demographics, history of previous abdominal surgery, operative time, or intraoperative complications. The rate of conversion to open cholecystectomy was 1.42% for consultant and none for resident (p = 0.02). A statistically significant difference was observed between groups regarding the average length of stay (2.2 ± 3 vs 1.6 ± 1.3 days p = 0.03). Similarly, postoperative complications (1.7% vs 0.5%) resulted in statistically significant (p = 0.02) favoring resident group.

Conclusions: Our study demonstrates that in selected patients, senior residents can safely perform LC when supervised by senior staff surgeons.

Keywords: Elective cholecystectomy; Laparoscopic cholecystectomy; Operative time; Resident education; Surgical education.

PubMed Disclaimer

References

1. Agresta F, Campanile FC, Vettoretto N, Silecchia G, Bergamini C, Maida P et al. Italian Surgical Societies Working Group (2015) Laparoscopic cholecystectomy: consensus conference-based guidelines. Langenbecks Arch Surg 400(4):429-53. https://doi.org/10.1007/s00423-015-1300-4
1. Okamoto K, Suzuki K, Takada T, Strasberg SM, Asbun HJ, Endo I et al (2019) Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci 25(1):55–72. https://doi.org/10.1002/jhbp.516 - DOI
1. Pisano M, Allievi N, Gurusamy K, Borzellino G, Cimbanassi S, Boerna D et al (2020) 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg 15(1):61. https://doi.org/10.1186/s13017-020-00336-x - DOI - PubMed - PMC
1. Morino M, Festa V, Garrone C, Mabilia MA, Olivieri F (1992) La colecistectomia per via laparoscopica. I nostri primi 70 casi [Cholecystectomy by the laparoscopic route. Our first 70 cases]. Minerva Chir 47(6):375–7 - PubMed
1. Reddick EJ, Olsen DO (1989) Laparoscopic laser cholecystectomy. A comparison with mini-lap cholecystectomy. Surg Endosc 3:131–133 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Springer

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents

Affiliations

Multicenter retrospective cohort Italian study on elective laparoscopic cholecystectomy performed by the surgical residents

Authors

Affiliations

Erratum in

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources