[Laparoscopic cholecystectomy and continuing surgical education].

The rapid spread of laparoscopic cholecystectomy as standard operative treatment of cholelithiasis raises the question whether this new technique can be learned as prescribed for the traditional training of surgeons. To answer this question traditional methods of instruction were used for the first consecutive 100 laparoscopic cholecystectomies after the instructors had seen the method elsewhere and learned by operations on animals. 15 surgeons operated on these 100 patients (23 men and 77 women; mean age 50 [20-79] years). In accordance with the concept of early integration of laparoscopic cholecystectomy into surgical training, two trainee surgeons who had not yet performed a conventional cholecystectomy also took part in laparoscopic cholecystectomies. There were one serious (damage to the hepatocholedochal duct) and two mild (postoperative colics) complications. The median duration of operation was 95 (30-240) min. In eight patients the intervention was continued as a conventional cholecystectomy. This experience demonstrates that training in laparoscopic surgery can follow the same path as that for conventional surgery. A prerequisite is responsible assistance by an experienced operator, after the method has been introduced into the hospital.