Educational Scoring System in Laparoscopic Cholecystectomy: Is It the Right Time to Standardize?
Elisa Reitano,
Simone Famularo,
Bernard Dallemagne,
Kohei Mishima,
Silvana Perretta,
Pietro Riva,
Pietro Addeo,
Horacio J. Asbun,
Claudius Conrad,
Nicolas Demartines,
David Fuks,
Mariano Gimenez,
Melissa E. Hogg,
Charles Chung-Wei Lin,
Jacques Marescaux,
John B. Martinie,
Riccardo Memeo,
Olivier Soubrane,
Michel Vix,
Xiaoying Wang,
Didier Mutter
Affiliations
Elisa Reitano
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Simone Famularo
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Bernard Dallemagne
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Kohei Mishima
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Silvana Perretta
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Pietro Riva
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Pietro Addeo
Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098 Strasbourg, France
Horacio J. Asbun
Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
Claudius Conrad
Department of Surgery, St. Elizabeth’s Medical Center, School of Medicine, Boston University, Boston, MA 02135, USA
Nicolas Demartines
Service de Chirurgie Viscérale, Département de Chirurgie, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
David Fuks
Department of Digestive Surgery, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
Mariano Gimenez
Institut Hospitalo-Universitaire-Strasbourg (IHU-Strasbourg), 67200 Strasbourg, France
Melissa E. Hogg
Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, USA
Charles Chung-Wei Lin
Show Chwan Memorial Hospital, Changhua 505, Taiwan
Jacques Marescaux
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
John B. Martinie
Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 600, Charlotte, NC 28204, USA
Riccardo Memeo
Hepato-Pancreato-Biliary Surgery Unit, Miulli Hospital, Acquaviva delle Fonti, 70124 Bari, Italy
Olivier Soubrane
Institut Mutualiste Montsouris, Université Paris Descartes, 75014 Paris, France
Michel Vix
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Xiaoying Wang
Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200433, China
Didier Mutter
Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France
Background and Objectives: Laparoscopic cholecystectomy (LC) is one of the most performed surgeries worldwide. Procedure difficulty and patient outcomes depend on several factors which are not considered in the current literature, including the learning curve, generating confusing and subjective results. This study aims to create a scoring system to calculate the learning curve of LC based on hepatobiliopancreatic (HPB) experts’ opinions during an educational course. Materials and Methods: A questionnaire was submitted to the panel of experts attending the HPB course at Research Institute against Digestive Cancer-IRCAD (Strasbourg, France) from 27–29 October 2022. Experts scored the proposed variables according to their degree of importance in the learning curve using a Likert scale from 1 (not useful) to 5 (very useful). Variables were included in the composite scoring system only if more than 75% of experts ranked its relevance in the learning curve assessment ≥4. A positive or negative value was assigned to each variable based on its effect on the learning curve. Results: Fifteen experts from six different countries attended the IRCAD HPB course and filled out the questionnaire. Ten variables were finally included in the learning curve scoring system (i.e., patient body weight/BMI, patient previous open surgery, emergency setting, increased inflammatory levels, presence of anatomical bile duct variation(s), and appropriate critical view of safety (CVS) identification), which were all assigned positive values. Minor or major intraoperative injuries to the biliary tract, development of postoperative complications related to biliary injuries, and mortality were assigned negative values. Conclusions: This is the first scoring system on the learning curve of LC based on variables selected through the experts’ opinions. Although the score needs to be validated through future studies, it could be a useful tool to assess its efficacy within educational programs and surgical courses.
