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The Influence of Surgeon Subspecialty in Laparoscopic Cholecystectomy : A Population-Based Study

Gustafsson, Arvid LU orcid ; Blohm, My ; Tingstedt, Bobby LU and Olsson, Greger LU (2026) In Journal of Investigative Surgery 39(1).
Abstract

Background: Laparoscopic cholecystectomy (LC) is performed by surgeons from various specialties and remains central to minimally invasive surgical training. This study assessed whether surgeon subspecialty affects patient outcomes and explored aspects of LC education. Methods: This population-based study included 46,700 LCs performed between 2020 and 2023, using data from the Swedish Registry for Gallstone Surgery (GallRiks). Surgeons were categorized as resident surgeons (RS), attending surgeons (AS), upper gastrointestinal/hepatopancreatobiliary surgeons (UGIS), acute care surgeons (ACS), or alternate subspecialty surgeons (ASS). Primary outcomes were 30-day adverse events (AE), bile duct injuries (BDI), and operative time (OT).... (More)

Background: Laparoscopic cholecystectomy (LC) is performed by surgeons from various specialties and remains central to minimally invasive surgical training. This study assessed whether surgeon subspecialty affects patient outcomes and explored aspects of LC education. Methods: This population-based study included 46,700 LCs performed between 2020 and 2023, using data from the Swedish Registry for Gallstone Surgery (GallRiks). Surgeons were categorized as resident surgeons (RS), attending surgeons (AS), upper gastrointestinal/hepatopancreatobiliary surgeons (UGIS), acute care surgeons (ACS), or alternate subspecialty surgeons (ASS). Primary outcomes were 30-day adverse events (AE), bile duct injuries (BDI), and operative time (OT). Educational activity and subgroup analyses for elective and acute cholecystitis cases were evaluated. Results: AE rates were higher for ACS (9.6%; OR 1.22, 95% CI 1.07–1.40) and AS (7.9%; OR 1.17, 95% CI 1.06–1.19) compared to UGIS (6.9%) but without increased BDI rates. RS demonstrated similar AE rates (6.1%) but lower BDI rates in elective cases (0.08%). OT was 24–33 min shorter for UGIS than for other surgeon types. Educational activity prolonged OT by 12 min (OR 1.06; 95% CI 1.05–1.08). Discussion: Higher AE rates among ACS and AS likely reflect more complex cases. LC performed by RS appears equally safe and efficient, provided appropriate supervision is available.

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Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adverse events, laparoscopic cholecystectomy, operative time, surgeon subspecialty, surgical education
in
Journal of Investigative Surgery
volume
39
issue
1
article number
2621464
publisher
Taylor & Francis
external identifiers
  • scopus:105029608888
  • pmid:41644420
ISSN
0894-1939
DOI
10.1080/08941939.2026.2621464
language
English
LU publication?
yes
id
b2ac1e51-7c6c-4c02-b32f-7ccf327b02e7
date added to LUP
2026-03-02 10:08:48
date last changed
2026-03-16 11:18:06
@article{b2ac1e51-7c6c-4c02-b32f-7ccf327b02e7,
  abstract     = {{<p>Background: Laparoscopic cholecystectomy (LC) is performed by surgeons from various specialties and remains central to minimally invasive surgical training. This study assessed whether surgeon subspecialty affects patient outcomes and explored aspects of LC education. Methods: This population-based study included 46,700 LCs performed between 2020 and 2023, using data from the Swedish Registry for Gallstone Surgery (GallRiks). Surgeons were categorized as resident surgeons (RS), attending surgeons (AS), upper gastrointestinal/hepatopancreatobiliary surgeons (UGIS), acute care surgeons (ACS), or alternate subspecialty surgeons (ASS). Primary outcomes were 30-day adverse events (AE), bile duct injuries (BDI), and operative time (OT). Educational activity and subgroup analyses for elective and acute cholecystitis cases were evaluated. Results: AE rates were higher for ACS (9.6%; OR 1.22, 95% CI 1.07–1.40) and AS (7.9%; OR 1.17, 95% CI 1.06–1.19) compared to UGIS (6.9%) but without increased BDI rates. RS demonstrated similar AE rates (6.1%) but lower BDI rates in elective cases (0.08%). OT was 24–33 min shorter for UGIS than for other surgeon types. Educational activity prolonged OT by 12 min (OR 1.06; 95% CI 1.05–1.08). Discussion: Higher AE rates among ACS and AS likely reflect more complex cases. LC performed by RS appears equally safe and efficient, provided appropriate supervision is available.</p>}},
  author       = {{Gustafsson, Arvid and Blohm, My and Tingstedt, Bobby and Olsson, Greger}},
  issn         = {{0894-1939}},
  keywords     = {{adverse events; laparoscopic cholecystectomy; operative time; surgeon subspecialty; surgical education}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Journal of Investigative Surgery}},
  title        = {{The Influence of Surgeon Subspecialty in Laparoscopic Cholecystectomy : A Population-Based Study}},
  url          = {{http://dx.doi.org/10.1080/08941939.2026.2621464}},
  doi          = {{10.1080/08941939.2026.2621464}},
  volume       = {{39}},
  year         = {{2026}},
}