ArticleSurgical endoscopy2023
Learning curve of laparoscopic cholecystectomy: a risk-adjusted cumulative summation (RA-CUSUM) analysis of six general surgery residents.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 13 citations in OpenAlex.
- Does mental imagery make a difference in virtual reality simulation training? Results of a randomized controlled trial.Surgical endoscopy · 2025Trial
- Building Surgical Capacity Through Multidisciplinary Laparoscopic Cholecystectomy Training in Kampong Cham, Cambodia.World journal of surgery · 2026Article
- Learning curve and surgical time predictors in robot-assisted transvaginal natural orifice transluminal endoscopic surgery: a risk-adjusted cumulative sum analysis.Journal of robotic surgery · 2026Article
- Point-of-care ultrasound for emergency pericardiocentesis: a multidimensional CUSUM analysis of the learning curve.BMC cardiovascular disorders · 2026Article
- Cholecystectomy inhibits fasting hepatic fatty acid oxidation in mice.Communications biology · 2026Article
- Feasibility and learning curve of a standardized laparoscopic cholecystectomy technique using a reusable bipolar device: a risk-adjusted CUSUM analysis of 780 cases operated by surgical trainees.Surgical endoscopy · 2025Article
- Evaluating the learning curve in robot-assisted laparoscopic total hysterectomy: single-port versus multi-port Da Vinci platforms.Journal of robotic surgery · 2025Article
- Evaluating the learning curve for single-port radical prostatectomy: a multi-institutional cohort analysis.World journal of urology · 2025Article
- Learning curve of robot-assisted laparoscopic partial nephrectomy surgery via the transperitoneal approach: a CUSUM analysis.Journal of robotic surgery · 2025Article
- Cystic Duct Diameter as a Key Predictor for Closure Difficulties in Laparoscopic Cholecystectomy.Cureus · 2025Article
- Machine learning algorithms as early diagnostic tools for prolonged operative time in patients with fluorescent laparoscopic cholecystectomy: a retrospective cohort study.Frontiers in surgery · 2025Article
- Learning curve of ultrasound-guided caudal epidural block: a CUSUM pivotal analysis.Frontiers in medicine · 2025Article
- Early learning curve changes in objective performance indicators during robotic cholecystectomy.Frontiers in surgery · 2025Article
- Factors contributing to prolonged operative time for laparoscopic cholecystectomy performed by trainee surgeons: a retrospective single-center study.Surgery today · 2024Article
- Comparative Analysis of Learning Curves in Robotic Versus Laparoscopic Cholecystectomy: A Systematic Review.Cureus · 2024Review
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic cholecystectomy (LapC) is one of the most frequently performed surgical procedures worldwide. Reaching technical competency in performing LapC is considered one essential task for young surgeons. Investigating the learning curve for LapC (LC-LapC) may provide important information regarding the learning process and guide the training pathway of residents, improving educational outcomes. The present study aimed to investigate LC-LapC among general surgery residents (GSRs).
methodsOperative surgical reports of consecutive patients undergoing LapC performed by GSRs attending the General Surgery Residency Program at the University of Milan were analysed. Data on patient- and surgery-related variables were obtained from the ICD-9-CM diagnosis codes and gathered. A multidimensional assessment of the LC was performed through Cumulative Sum (CUSUM) and Risk-Adjusted (RA)-CUSUM analysis.
results340 patients operated by 6 GSRs were collected. The CUSUM and RA-CUSUM graphs based on surgical failures allowed to distinguish two defined phases for all GSRs: an initial phase ending at the peak, so-called learning phase, followed by a phase in which there was a significant decrease in failure incidence, so-called proficiency phase. The learning phase was completed for all GSRs at most within 25 procedures, but the trend of the curves and the number of procedures needed to achieve technical competency varied among operators ranging between 7 and 25.
conclusionsThe present study suggested that at most 25 procedures might be sufficient to acquire technical competency in LapC. The variability in the number of procedures needed to complete the LC, ranging between 7 and 25, could be due to the heterogeneous scenarios in which LapC was performed, and deserves to be investigated through a prospective study involving a larger number of GSRs and institutions.
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