Online citations, reference lists, and bibliographies.

The Decline Of Training In Open Biliary Surgery

Richard S. Chung, L. Wojtasik, Q. Pham, Vijaylaxmi Chari, P. Chen
Published 2002 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
Share
Background: After more than a decade of growth for laparoscopic cholecystectomy and decline in open cholecystectomy, the impact on the training of resident's in other open biliary operations can be analyzed quantitatively. Methods: The national operative statistics for residents’ operations from 1988 to 2001 (data in the public domain) were analyzed by regression analysis to establish trends and to calculate the rate of change. For laparoscopic biliary operations, the changes in laparoscopic and open operations over time and the number of operations per trainee each year were used to measure the growth of a laparoscopic operation and to predict future trends. A survey of attitude, management algorithm, and self-confidence for coping with unexpected events in laparoscopic cholecystectomy also was conducted for senior residents and recent graduates. Results: In 2001, open cholecystectomy decreased to 28%, open common duct exploration to 27%, sphincteroplasty to 20%, of 1988 (baseline year) levels. Cholecystostomy and choledochoenteric bypass decreased to 70% and 75%, respectively. The decline began before the era of laparoscopic cholecystectomy, but accelerated after its introduction. Many of the recent graduates surveyed in one program indicated a preference for a nonsurgical, mainly endoscopic, approach for all bile duct conditions, but also for the assistance of senior surgeons in the operative management of unexpected events. Conclusion: The popularity of noninvasive therapy in biliary surgery significantly reduced the resident's exposure to open biliary surgery, adversely affecting their confidence in the management of unexpected events encountered during laparoscopic operations. Supplemental and remedial education measures must be instituted in training programs.
This paper references



This paper is referenced by
10.1007/s00464-018-6333-7
Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era
Christopher W. Mangieri (2018)
10.1016/j.ijsu.2018.01.037
Open cholecystectomy: Exposure and confidence of surgical trainees and new fellows.
Beth M. Campbell (2018)
3 Gallbladder Surgery , Choice of Technique : An Overview
Elliot Nilsson (2019)
10.1007/s00464-020-07759-2
Less is more in the difficult gallbladder: recent evolution of subtotal cholecystectomy in a single HPB unit
Michael Thomas LeCompte (2020)
10.1016/j.jss.2012.04.021
Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents.
Ido Mizrahi (2013)
10.1016/j.jamcollsurg.2016.02.019
Who Will Be Able to Perform Open Biliary Surgery in 2025?
Kenneth R. Sirinek (2016)
10.1007/s12262-010-0060-1
Open common bile duct exploration without T-tube insertion- two decade experience from a limited resource setting in the Caribbean
Vijay Naraynsingh (2010)
10.5772/20647
Gallbladder Surgery, Choice of Technique: An Overview
Erik Nilsson (2011)
10.1007/978-3-319-22765-8_8
Special Considerations for the Surgeon
Michael P. Meara (2016)
10.1016/j.jsurg.2012.08.007
Open surgical simulation in residency training: a review of its status and a case for its incorporation.
Annabelle L. Fonseca (2013)
10.1016/j.amjsurg.2020.02.032
A review of general surgery resident experience in common bile duct exploration in the ERCP era.
Rachel L Warner (2020)
Minilaparotomy cholecystectomy--an appropriate alternative to laparoscopic cholecystectomy in developing nations.
Vijay Naraynsingh (2010)
10.1097/SLA.0b013e3181c1b18e
The Impact of Minimally Invasive Surgery on Residents' Open Operative Experience: Analysis of Two Decades of National Data
Raphael S. Chung (2010)
10.1016/j.jsurg.2010.08.001
The impact of laparoscopy on the volume of open cases in general surgery training.
Fuad Alkhoury (2010)
10.1186/1471-230X-7-35
Cholecystectomy in Sweden 2000 – 2003: a nationwide study on procedures, patient characteristics, and mortality
Mats Rosenmüller (2007)
10.1016/j.jsurg.2012.05.005
A solution to the decreased resident exposure to open operations in the era of minimally invasive surgery and restricted duty hours may be with organ procurement and transplantation surgery.
Joseph W Gunter (2012)
10.1007/s00268-012-1648-3
Treatment of Common Bile Duct Stones in Sweden 1989–2006: An Observational Nationwide Study of a Paradigm Shift
Birger Sandzén (2012)
10.1186/1471-2482-6-5
Open cholecystectomy for all patients in the era of laparoscopic surgery – a prospective cohort study
Jonas Leo (2006)
10.1007/s13126-017-0372-8
Is primary closure of common bile duct a rational method after choledocholithotomy, in a low resource setting?
Sumitra Hagjer (2017)
Small Incision Open Cholecystectomy ( SIOC ) in the Era of Laparoscopic Surgery : A Prospective Cohort Study
Dr. Niranjan Dash (2014)
Cholecystectomy through Mini Laparotomy Incision
Nasrullah Khan (2009)
10.4103/1687-1693.180459
Evaluation of primary repair of common bile duct in common bile duct stones
Mohamed Abdelraheem (2016)
10.1016/j.surg.2019.04.042
Gas off, room lights on: Shedding light on the surgical resident's experience in open and laparoscopic surgery.
Ralph Cutler Quillin (2019)
10.1016/J.YASU.2014.05.010
What is wrong with the training of general surgery?
Daniel T. McKenna (2014)
10.1016/j.surg.2012.02.016
Laparoscopic cholecystectomy: What is the price of conversion?
Balazs I. Lengyel (2012)
10.1016/j.amjsurg.2010.01.012
The changing face of the general surgeon: national and local trends in resident operative experience.
Matthew J. Eckert (2010)
Semantic Scholar Logo Some data provided by SemanticScholar