Fique Memon M Rafique, Salim Ahmed Soomro, Asif Qureshi, Mumtaz Maher.
Laparoscopic cholecystectomy in the hands of postgraduate trainees: the need for guidelines.
Pak J Surg Jan ;26(2):125-9.

Objective: The purpose of this study is to evaluate the safety of elective Laparoscopic Cholecystectomy done by post-graduate trainees under supervision and the introduction of proper training of Laparoscopic surgery in post-graduate residency programs. Design: Descriptive study. Material and Methods: This study includes 800 cases undergoing Laparoscopic Cholecystectomy for symptomatic gall-stones, conducted at surgical ward 2, Jinnah Post-graduate Medical Center Karachi, during a period of last 5 years (Jan 2004 to Dec 2008). These Laparoscopic Cholecystectomies were performed by post-graduate trainees under supervision of senior laparoscopic surgeon (Professor). Results: Among 800 cases, there are 200 (25 %) males and 600 (75 %) females. The age of patients ranged from 18-70 years. All the cases were done by residents of year III & IV with minimal complications. The results and observations were made for the operating time, diffi culty in dissection, open conversion rate and complications. The mean operating time is 60 minutes. The open conversion is 1.5 %. CBD and gut injury is 0.37% and 0.12 % respectively. Mortality is 0.25% because of hepatic failure in patients with decompensated cirrhosis. Conclusion: Laparoscopic Cholecystectomy is integrated early in surgical training according to the concept “Observe, Assist, and then Operate under the assistance of an experienced laparoscopic surgeon”. The introduction of clinical laparoscopic training into general surgery residency programs should infl uence the widespread adoption of this new procedure.

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