Multicenter Italian academic experience of elective laparoscopic cholecystectomy performed by the surgical residents

Abstract

Purpose: This retrospective study aimed to evaluate the clinical outcomes (mortality rate, operative time, complications) of elective LC when performed by a surgical resident in the backdrop of Italian academic centers.Methods: A 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 (group A) or senior resident (group B).Results: A total of 2331 cases (1425 females) were included, of which, consultants performed 1683 LCs, while the residents performed 648 surgeries. The groups were statistically comparable regarding demographics, history of previous abdominal surgery, operative time, or intraoperative complications (p > 0.05). The rate of conversion to open cholecystectomy was 1.42% for group A and none for Group B. However, a statistically significant difference was observed between groups A and B regarding the average length of stay and postoperative complications (2.2 ± 3 versus 1.6 ± 1.3 days, and 1.7% versus 0.5%, respectively; p < 0.05 each). Conclusions: Our study demonstrates that in selected patients, senior residents can safely perform LC when supervised by senior staff surgeons.