Laparoscopic Cholecystectomy: Whatʼs So Special?

One hundred seventy-one laparoscopic cholecystectomies were done by senior surgery residents who received only traditional "hands-on" training. Eight patients (5%) required conversion to open cholecystectomy, and two had complications requiring immediate celiotomy (one common bile duct injury, one "dropped" gallbladder). The average operative time was 91 minutes (range, 30 to 245 minutes). There were no deaths and only five postoperative complications related to the procedure (retained common bile duct stone in four cases, intra-abdominal hemorrhage in one). There were three complications unrelated to the procedure. Data 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 program provides adequate opportunity for training surgeons in the techniques of laparoscopic cholecystectomy; there is no need to attend an expensive and time-consuming classroom and animal laboratory course.