TPTh 2.01 Is Emergency Laparoscopic Cholecystectomy a Safe Training Procedure – A Single Centre Retrospective Study

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Abstract Aims To evaluate differences in intra-operative metrics and post-operative outcomes between consultant- and trainee-operator emergency laparoscopic cholecystectomy. Methods All emergency laparoscopic cholecystectomies between August 2023 and December 2024 at a single tertiary centre were included in a retrospective analysis (n = 914). Outcomes were compared between consultant and trainee primary operator cases. Results 392 (42.9%) operations were consultant-led, 498 (54.5%) registrar/fellow-led and 24 (2.6%) core trainee-led. There were no inter-group differences in age, gender or ASA grade. Consultant-led cases had longer pre-admission (p = 0.018), total symptom duration (p = 0.001), time from booking to theatre (p < 0.001), and were more frequently ambulatory pre-operatively (p = 0.003). Consultant-led cases had higher complications rates (p = 0.02), more Clavien–Dindo grade 3 complications (p = 0.006) and higher re-intervention rates (p < 0.001). Excluding day-case procedures, consultant-led cases had longer post-operative stay (p < 0.001), with no differences in readmissions or reattendances. Excluding biliary colic, consultant-led cases had higher Clavien–Dindo grade 3 complications (p = 0.008), higher re-intervention rates (p < 0.001) and longer post-operative stay (p < 0.001). Median procedure length for trainees was statistically but not clinically longer (83 vs 87 minutes, p = 0.02). Conclusions Emergency laparoscopic cholecystectomy performed by trainees is not associated with increased adverse outcomes, longer post-operative stay or clinically important increases in operating time. With appropriate case selection, robust supervision and oversight, these cases are safe and appropriate for training.

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