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

Autor: Iossa A; 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., Micalizzi A; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., Giuffrè M; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., Ciccioriccio MC; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., Termine P; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., De Angelis F; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., Boru CE; Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome-Polo Pontino, ICOT Hospital, 'La Sapienza, Latina, Italy., Di Buono G; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Salzano A; Department of Surgical Sciences, University of Turin, Citta della Salute e della Scienza Hospital, Turin, Italy., Chiozza M; Department of Morphology, Surgery and Experimental Medicine, Sant'Anna University Hospital, University of Ferrara, Ferrara, Italy., Agostini C; Department of Digestive Surgery, Careggi University Hospital, Florence, Italy., Silvestri V; Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy., Agrusa A; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Anania G; Department of Morphology, Surgery and Experimental Medicine, Sant'Anna University Hospital, University of Ferrara, Ferrara, Italy., Bracale U; Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy., Coratti F; Department of Digestive Surgery, Careggi University Hospital, Florence, Italy., Cavallaro G; Department of Surgery 'P. Valdoni', Head-General Surgery Unit, University of Rome, ICOT Hospital, La Sapienza', Latina, Italy., Corcione F; Department of Gastroenterology, Endocrinology and Surgical Endoscopy, University Hospital Federico II of Naples, Naples, Italy., Morino M; Department of Surgical Sciences, University of Turin, Citta della Salute e della Scienza Hospital, Turin, Italy., Silecchia G; Department of Medical-Surgical Sciences and Translation Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2022 Dec 29; Vol. 408 (1), pp. 3. Date of Electronic Publication: 2022 Dec 29.
DOI: 10.1007/s00423-022-02738-8
Abstrakt: 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.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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