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LEARNING CURVE ON INTRA‐OPERATIVE CHOLANGIOGRAM IN THE PERSPECTIVE OF NEW SURGEONS
Author(s) -
Ashrafi M. W.,
Pandey S. K.,
Ghojavand H.,
Robertsthomson J.,
Brockwell D.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04929_10.x
Subject(s) - medicine , laparoscopic cholecystectomy , general surgery , cholecystectomy , common bile duct , bile duct , perspective (graphical) , surgery , artificial intelligence , computer science
Purpose:1 To discuss the constraints of learning intraoperative cholangiograms (IOC) especially in rural hospitals. 2 To emphasize that the option of doing it or not is totally dependent on the supervisors personal choice and practice.Methodology: Retrospectively we have gone through the list of 450 cases of laparoscopic cholecystectomy done in a Tasmanian rural hospital. 15 surgeons have been involved as operators. It is obviously noticeable that particular surgeons are trying routine cholangiogram and some never try this. Over the time volumes of available literatures engaged their time to debate for or against ‘routine cholangiogram’. But no final verdict has been ascertained. For us in a small centre where we don't have ERCP expertise debate is even louder. Though laparoscopic cholecystectomies are mostly done by registrars with supervisors scrubbed or unscrubbed they have to follow the footprint of the unit in charge. Results: Practical skills come to the hands of trainees through supervised number of particular techniques of the procedures. Peroperative cholangiogram to us is step 1 of proceeding towards common bile duct exploration, when needed. Though the yield percentage of the IOC is low, the procedure can not be considered as an expeditive surgical procedure and it will remain in the list of popular surgical practice among the contemporary surgeons and in foreseeable future. Conclusion:1 For training purpose junior surgeons should be increasingly exposed to IOC. 2 IOC can identify missed stones, biliary anatomy and complications of Laparoscopic Cholecystectomy immediately.