Page 51 - Journal of World Association of Laparoscopic Surgeons

CASE REPORT
Review of Outcome of Laparoscopic Cholecystectomy

Done by Consultants vs Surgery Residents at Tertiary Care

Teaching Hospital

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Jasmine R Agarwal , Jitendra T Sankpal , Ratnaprabha P Jadhav , Shubham D Gupta , Supriya S Bhondve ,
Ruchira R Bhattacharya 6
AbstrAct
Objective: The aim of this study was to assess morbidity, mortality, and outcome in selected patients after laparoscopic cholecystectomy (LC)
performed by consultants or by surgical residents at Gokuldas Tejpal Hospital affiliated to Grant Government Medical College and Sir JJ group
of Government Hospitals in Mumbai, India
Materials and methods: Between January 1, 2013 and December 31, 2016, 342 laparoscopic cholecystectomies were performed, 111 by residents
and 231 by consultants. The routine blood investigations of all the patients were sent and they all had electrocardiography, chest X-ray, and
abdominal ultrasound scan done preoperatively. All patients were induced with general anesthesia.
Results: Six conversions were required to an open procedure (four in the resident group and two in the group of consultants) because of
impossible recognition of anatomy around Calot’s triangle. The mean operative time was 59 minutes for the residents while for the consultants
it was 47 minutes. Mortality rate was 0% in both groups. There were 27 major complications, 12 in the resident group and 15 in the consultant
group. The mean hospital stay was 3.5 days and 2.3 days for patients operated by the residents and the consultants, respectively, while all the
patients resumed their normal activities after 16.7 days and 15.1 days respectively.
Conclusion: Supervised LC performed by surgical residents does not increase surgical morbidity and does not compromise patient outcome.
Keywords: Cholecystecomy, Cholelithiasis, Complications, Laparoscopy, Outcome, Surgical training.
World Journal of Laparoscopic Surgery (2019): 10.5005/jp-journals-10033-1363

IntroductIon 1 Department of General Surgery, Sir JJ Group of Hospitals, New Delhi,

The discipline of surgery has become even more complex with the India
rapid introduction of revolutionary technologies. Laparoscopic 2 Department of General Surgery, Sir JJ Group of Hospitals, Mumbai,
surgery is the simplest and first of those new directions. Several Maharashtra, India
authors have described the establishment of laparoscopic 3 Department of General Surgery, Sir JJ Group of Hospitals, Nanded,
cholecystectomy (LC) as a standard method and the associated Maharashtra, India
learning curves. 1–3 4 Department of General Surgery, Sir JJ Group of Hospitals, Datia,
As the new technologies are introduced into our hospitals, our Madhya Pradesh, India
operative tables must be evaluated on multiple levels. Laparoscopic 5 Department of General Surgery, Sir JJ Group of Hospitals, Ahmednagar,
and robotic surgeries have created a need for advanced and Maharashtra, India
different skills and abilities that both practicing surgeons and 6 Department of General Surgery, Sir JJ Group of Hospitals, Kolkata,
trainees should be familiar with. Training of future surgeons is a West Bengal, India
task of vital importance to the society. Since the introduction of Corresponding Author: Jasmine R Agarwal, Department of General
the laparoscopic technique in 1985, LC has become the preferred Surgery, Sir JJ Group of Hospitals, New Delhi, India, Phone: +91
4
procedure. Some authors emphasize on the importance of LC 8510010756, e-mail: jasmineagarwal2810@gmail.com
because junior residents are performing a number of laparoscopic How to cite this article: Agarwal JR, Sankpal JT, Jadhav RP, et al. Review
procedures under direct supervision, and an increasing number of Outcome of Laparoscopic Cholecystectomy Done by Consultants vs
of LCs. 5 Surgery Residents at Tertiary Care Teaching Hospital. World J Lap Surg
This is a retrospective study aiming to compare the outcome, 2019;12(1):43–44.
efficacy, and morbidity rates between patients who underwent LC Source of support: Nil

by consultants and surgical trainees. Conflict of interest: None

MAterIAls And Methods on by three surgical residents, and the other 231 patients by

three consultants.
Between January 1, 2013 and December 31, 2016, 342 patients In India, surgical residents begin to assist and operate under
underwent LC at Gokuldas Tejpal Hospital, affiliated to Grant close supervision in the second or third year of their residency as
Government Medical College and Sir JJ group of Government per Medical Council of India. LC was done with the patient under
Hospitals in Mumbai, India. Of these 342, 111 patients were operated general anesthesia.

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