PubMed · 8114232
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P R Caropreso. 1994-03-16. The learning curve.. https://doi.org/10.1001/jama.271.11.824a
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OBJECTIVE: To assess the difference in safety of laparoscopic cholecystectomy performed by residents and staff surgeons. SETTING: St. Antonius Hospital, Nieuwegein, the Netherlands. DESIGN: Retrospective study. METHOD: Results of 649 laparoscopic cholecystectomies performed by staff surgeons experienced in laparoscopic surgery, by residents under supervision of a staff surgeon, by residents without supervision and by inexperienced surgeons, were compared. RESULTS: Patients were comparable, except for liver function disorders and raised sedimentation rates, of which there were more in the group operated by the non-supervised residents, compared with the staff surgeons. Average operation time was 57 minutes in all four groups. Non-supervised residents had more retained stones than staff surgeons (19 vs 6%) and reported more bleeding during surgery than staff surgeons (21 vs 8%). Conversion rate was the same (3.9%) in all four groups. Complications occurred in 5.7%; this also was the same in the four groups. CONCLUSION: Residents following a traditional surgical training without practice on animals, perform laparoscopic cholecystectomy as quickly as and with the same conversion and complication rates as their teachers.