Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?
Objective: To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure. Design: Prospectively documented series, retrospective analysis. Setting: University teaching hospital, Austria. Subjects: 581 consecutive patients who underwent elective LC for sympto...
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| Veröffentlicht in: | The European journal of surgery 2002-01, Vol.168 (8-9), p.470-474 |
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| container_issue | 8-9 |
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| container_title | The European journal of surgery |
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| creator | Imhof, M. Zacherl, J. Rais, A. Lipovac, M. Jakesz, R. Fuegger, R. |
| description | Objective:
To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure.
Design:
Prospectively documented series, retrospective analysis.
Setting:
University teaching hospital, Austria.
Subjects:
581 consecutive patients who underwent elective LC for symptomatic cholelithiasis between January 1993 and December 1997.
Interventions:
LC were allocated to three groups: the first (n = 91) were done by supervised beginners (who had done fewer than 11 LC), the second (n = 249) by supervised trainees who had a little experience (they had done more than 10 but fewer than 51 LC), and the third group (n = 241) who were experienced surgeons (they had done more than 50 LC).
Main outcome measures:
Minor and major complications, conversion and reoperation rate, length of operation and postoperative hospital stay.
Results:
The minor intraoperative complication rates were 36/91 (40%), 115/249 (46%) and 49/241 (20%), respectively (p < 0.001 when experienced surgeons were compared with the 2 trainees' groups). There were no significant differences between the three groups regarding major complications (1/91, 4/249 and 4/241), conversions (5/91, 21/249, and 17/241) and reoperation rate (1/91, 3/249 and 3/241), median (range) length of operation 82 (24–159), 84 (25–249) and 82 (21–234) minutes and hospital stay 4 (3–19), 4 (3–11) and 4 (2–15) days.
Conclusion:
Elective LC for symptomatic cholelithiasis done by trainees under supervision does not increase surgical morbidity. |
| doi_str_mv | 10.1080/110241502321116479 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72838999</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72838999</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4128-5f8f804f6eadc876737963e5bede78529cb4878fc727be6b898b00a526d2560a3</originalsourceid><addsrcrecordid>eNqNkUuP1DAQhC0EYh_wBzigXOAWsB0_uaDVsg_QCpAYtEfLcdo7hiQOdgbIv8ejjNgDF07llr6qVpcRekbwK4IVfk0IpoxwTBtKCBFM6gfomEhGak0leVjeBagLQY7QSc7fMMakkfQxOiKUMy2UPEbtBqzbhvGu6u1kU8wuTsFVbht7cEuewc1xWN5UXaxauAvjCClXtvtZBPqlst4Xopq3UMXd7OJQ1K_jBMnOIY5vn6BH3vYZnh70FH29vNicX9c3n67en5_d1I4RqmrulVeYeQG2c0oK2UgtGuAtdCAVp9q1TEnlnaSyBdEqrVqMLaeio1xg25yil2vulOKPHeTZDCE76Hs7QtxlI6lqlNa6gHQFXbk3J_BmSmGwaTEEm32z5t9mi-n5IX3XDtDdWw5VFuDFAbDZ2d4nO7qQ7znGqNZ4H8RW7lfoYfmP1ebiwxdVbPVqC-VTfv-12fTd7Kvi5vbjldncCvL5XcPNdfMHu7me9Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72838999</pqid></control><display><type>article</type><title>Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Imhof, M. ; Zacherl, J. ; Rais, A. ; Lipovac, M. ; Jakesz, R. ; Fuegger, R.</creator><creatorcontrib>Imhof, M. ; Zacherl, J. ; Rais, A. ; Lipovac, M. ; Jakesz, R. ; Fuegger, R.</creatorcontrib><description>Objective:
To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure.
Design:
Prospectively documented series, retrospective analysis.
Setting:
University teaching hospital, Austria.
Subjects:
581 consecutive patients who underwent elective LC for symptomatic cholelithiasis between January 1993 and December 1997.
Interventions:
LC were allocated to three groups: the first (n = 91) were done by supervised beginners (who had done fewer than 11 LC), the second (n = 249) by supervised trainees who had a little experience (they had done more than 10 but fewer than 51 LC), and the third group (n = 241) who were experienced surgeons (they had done more than 50 LC).
Main outcome measures:
Minor and major complications, conversion and reoperation rate, length of operation and postoperative hospital stay.
Results:
The minor intraoperative complication rates were 36/91 (40%), 115/249 (46%) and 49/241 (20%), respectively (p < 0.001 when experienced surgeons were compared with the 2 trainees' groups). There were no significant differences between the three groups regarding major complications (1/91, 4/249 and 4/241), conversions (5/91, 21/249, and 17/241) and reoperation rate (1/91, 3/249 and 3/241), median (range) length of operation 82 (24–159), 84 (25–249) and 82 (21–234) minutes and hospital stay 4 (3–19), 4 (3–11) and 4 (2–15) days.
Conclusion:
Elective LC for symptomatic cholelithiasis done by trainees under supervision does not increase surgical morbidity.</description><identifier>ISSN: 1102-4151</identifier><identifier>EISSN: 1741-9271</identifier><identifier>DOI: 10.1080/110241502321116479</identifier><identifier>PMID: 12549687</identifier><language>eng</language><publisher>UK: Taylor & Francis, Ltd</publisher><subject>Austria ; Biological and medical sciences ; cholecystectomy ; Cholecystectomy, Laparoscopic - education ; cholecystitis ; Cholelithiasis - surgery ; Clinical Competence ; complications ; Education, Medical, Continuing ; Humans ; laparoscopy ; Liver, biliary tract, pancreas, portal circulation, spleen ; Medical sciences ; minimally invasive surgery ; morbidity ; Postoperative Complications ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; surgical training ; teaching ; Treatment Outcome</subject><ispartof>The European journal of surgery, 2002-01, Vol.168 (8-9), p.470-474</ispartof><rights>Copyright © 2002 Taylor and Francis Ltd</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4128-5f8f804f6eadc876737963e5bede78529cb4878fc727be6b898b00a526d2560a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14429909$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12549687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Imhof, M.</creatorcontrib><creatorcontrib>Zacherl, J.</creatorcontrib><creatorcontrib>Rais, A.</creatorcontrib><creatorcontrib>Lipovac, M.</creatorcontrib><creatorcontrib>Jakesz, R.</creatorcontrib><creatorcontrib>Fuegger, R.</creatorcontrib><title>Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?</title><title>The European journal of surgery</title><addtitle>Eur J Surg</addtitle><description>Objective:
To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure.
Design:
Prospectively documented series, retrospective analysis.
Setting:
University teaching hospital, Austria.
Subjects:
581 consecutive patients who underwent elective LC for symptomatic cholelithiasis between January 1993 and December 1997.
Interventions:
LC were allocated to three groups: the first (n = 91) were done by supervised beginners (who had done fewer than 11 LC), the second (n = 249) by supervised trainees who had a little experience (they had done more than 10 but fewer than 51 LC), and the third group (n = 241) who were experienced surgeons (they had done more than 50 LC).
Main outcome measures:
Minor and major complications, conversion and reoperation rate, length of operation and postoperative hospital stay.
Results:
The minor intraoperative complication rates were 36/91 (40%), 115/249 (46%) and 49/241 (20%), respectively (p < 0.001 when experienced surgeons were compared with the 2 trainees' groups). There were no significant differences between the three groups regarding major complications (1/91, 4/249 and 4/241), conversions (5/91, 21/249, and 17/241) and reoperation rate (1/91, 3/249 and 3/241), median (range) length of operation 82 (24–159), 84 (25–249) and 82 (21–234) minutes and hospital stay 4 (3–19), 4 (3–11) and 4 (2–15) days.
Conclusion:
Elective LC for symptomatic cholelithiasis done by trainees under supervision does not increase surgical morbidity.</description><subject>Austria</subject><subject>Biological and medical sciences</subject><subject>cholecystectomy</subject><subject>Cholecystectomy, Laparoscopic - education</subject><subject>cholecystitis</subject><subject>Cholelithiasis - surgery</subject><subject>Clinical Competence</subject><subject>complications</subject><subject>Education, Medical, Continuing</subject><subject>Humans</subject><subject>laparoscopy</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Medical sciences</subject><subject>minimally invasive surgery</subject><subject>morbidity</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>surgical training</subject><subject>teaching</subject><subject>Treatment Outcome</subject><issn>1102-4151</issn><issn>1741-9271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUuP1DAQhC0EYh_wBzigXOAWsB0_uaDVsg_QCpAYtEfLcdo7hiQOdgbIv8ejjNgDF07llr6qVpcRekbwK4IVfk0IpoxwTBtKCBFM6gfomEhGak0leVjeBagLQY7QSc7fMMakkfQxOiKUMy2UPEbtBqzbhvGu6u1kU8wuTsFVbht7cEuewc1xWN5UXaxauAvjCClXtvtZBPqlst4Xopq3UMXd7OJQ1K_jBMnOIY5vn6BH3vYZnh70FH29vNicX9c3n67en5_d1I4RqmrulVeYeQG2c0oK2UgtGuAtdCAVp9q1TEnlnaSyBdEqrVqMLaeio1xg25yil2vulOKPHeTZDCE76Hs7QtxlI6lqlNa6gHQFXbk3J_BmSmGwaTEEm32z5t9mi-n5IX3XDtDdWw5VFuDFAbDZ2d4nO7qQ7znGqNZ4H8RW7lfoYfmP1ebiwxdVbPVqC-VTfv-12fTd7Kvi5vbjldncCvL5XcPNdfMHu7me9Q</recordid><startdate>20020101</startdate><enddate>20020101</enddate><creator>Imhof, M.</creator><creator>Zacherl, J.</creator><creator>Rais, A.</creator><creator>Lipovac, M.</creator><creator>Jakesz, R.</creator><creator>Fuegger, R.</creator><general>Taylor & Francis, Ltd</general><general>Taylor & Francis</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020101</creationdate><title>Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?</title><author>Imhof, M. ; Zacherl, J. ; Rais, A. ; Lipovac, M. ; Jakesz, R. ; Fuegger, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4128-5f8f804f6eadc876737963e5bede78529cb4878fc727be6b898b00a526d2560a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Austria</topic><topic>Biological and medical sciences</topic><topic>cholecystectomy</topic><topic>Cholecystectomy, Laparoscopic - education</topic><topic>cholecystitis</topic><topic>Cholelithiasis - surgery</topic><topic>Clinical Competence</topic><topic>complications</topic><topic>Education, Medical, Continuing</topic><topic>Humans</topic><topic>laparoscopy</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Medical sciences</topic><topic>minimally invasive surgery</topic><topic>morbidity</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>surgical training</topic><topic>teaching</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Imhof, M.</creatorcontrib><creatorcontrib>Zacherl, J.</creatorcontrib><creatorcontrib>Rais, A.</creatorcontrib><creatorcontrib>Lipovac, M.</creatorcontrib><creatorcontrib>Jakesz, R.</creatorcontrib><creatorcontrib>Fuegger, R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Imhof, M.</au><au>Zacherl, J.</au><au>Rais, A.</au><au>Lipovac, M.</au><au>Jakesz, R.</au><au>Fuegger, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation?</atitle><jtitle>The European journal of surgery</jtitle><addtitle>Eur J Surg</addtitle><date>2002-01-01</date><risdate>2002</risdate><volume>168</volume><issue>8-9</issue><spage>470</spage><epage>474</epage><pages>470-474</pages><issn>1102-4151</issn><eissn>1741-9271</eissn><abstract>Objective:
To evaluate the safety of elective laparoscopic cholecystectomy (LC) as a supervised teaching procedure.
Design:
Prospectively documented series, retrospective analysis.
Setting:
University teaching hospital, Austria.
Subjects:
581 consecutive patients who underwent elective LC for symptomatic cholelithiasis between January 1993 and December 1997.
Interventions:
LC were allocated to three groups: the first (n = 91) were done by supervised beginners (who had done fewer than 11 LC), the second (n = 249) by supervised trainees who had a little experience (they had done more than 10 but fewer than 51 LC), and the third group (n = 241) who were experienced surgeons (they had done more than 50 LC).
Main outcome measures:
Minor and major complications, conversion and reoperation rate, length of operation and postoperative hospital stay.
Results:
The minor intraoperative complication rates were 36/91 (40%), 115/249 (46%) and 49/241 (20%), respectively (p < 0.001 when experienced surgeons were compared with the 2 trainees' groups). There were no significant differences between the three groups regarding major complications (1/91, 4/249 and 4/241), conversions (5/91, 21/249, and 17/241) and reoperation rate (1/91, 3/249 and 3/241), median (range) length of operation 82 (24–159), 84 (25–249) and 82 (21–234) minutes and hospital stay 4 (3–19), 4 (3–11) and 4 (2–15) days.
Conclusion:
Elective LC for symptomatic cholelithiasis done by trainees under supervision does not increase surgical morbidity.</abstract><cop>UK</cop><pub>Taylor & Francis, Ltd</pub><pmid>12549687</pmid><doi>10.1080/110241502321116479</doi><tpages>5</tpages></addata></record> |
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| ispartof | The European journal of surgery, 2002-01, Vol.168 (8-9), p.470-474 |
| issn | 1102-4151 1741-9271 |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Austria Biological and medical sciences cholecystectomy Cholecystectomy, Laparoscopic - education cholecystitis Cholelithiasis - surgery Clinical Competence complications Education, Medical, Continuing Humans laparoscopy Liver, biliary tract, pancreas, portal circulation, spleen Medical sciences minimally invasive surgery morbidity Postoperative Complications Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system surgical training teaching Treatment Outcome |
| title | Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation? |
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