Evidence map›Paper›PMID 37910247›Full record

ArticleSurgical endoscopy2024

The Laparoscopy in Biliary Exploration Research and Training Initiative (LIBERTI) trial: simulator-based training for laparoscopic management of choledocholithiasis.

Vanessa N VanDruff, B Fernando Santos, Kristine Kuchta, Robin Cotter, Jenaya Goldwag, Ming Cai, Xavier Fowler, Casey R Lamb, Abigail J Uyrga, Michael Cutshall and 12 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 6 institutions in 1 country.

Vanessa N VanDruffDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA. Vanessa.vandruff@uchospitals.edu.ORCID 0000-0002-7610-1372
B Fernando SantosDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Kristine KuchtaDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
Robin CotterDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Jenaya GoldwagDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Ming CaiDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Xavier FowlerDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Casey R LambDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Abigail J UyrgaDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
Michael CutshallDepartment of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Brian R DavisDepartment of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Roxann A LermaDepartment of Minimally Invasive Surgery, University of New Mexico Hospital, Albuquerque, NM, USA.
Edward D AuyangDepartment of Minimally Invasive Surgery, University of New Mexico Hospital, Albuquerque, NM, USA.
Wendy LiDepartment of Surgery, Indiana University Health Hospital, Indianapolis, IN, USA.
Eugene P CeppaDepartment of Surgery, Indiana University Health Hospital, Indianapolis, IN, USA.
Edward JonesDepartment of Surgery, University of Colorado, Denver, CO, USA.
Danielle AbbittDepartment of Surgery, University of Colorado, Denver, CO, USA.
Julia R AmundsonDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
Stephanie JosephDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
H Mason HedbergDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
Michael McCormackDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
Michael B UjikiDepartment of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI Suite B665, Evanston, IL, 60201, USA.
NorthShore University HealthSystem · USDartmouth–Hitchcock Medical Center · USIndiana University Health · USTexas Tech University · USUniversity of Colorado Denver · USUniversity of New Mexico Hospital · US

Funding

Boston Scientific Corporation ISREND00116
6 · The paper itself

Abstract

backgroundLaparoscopic cholecystectomy with common bile duct exploration (LCBDE) is equivalent in safety and efficacy to endoscopic retrograde cholangiopancreatography (ERCP) plus laparoscopic cholecystectomy (LC) while decreasing number of procedures and length of stay (LOS). Despite these advantages LCBDE is infrequently utilized. We hypothesized that formal, simulation-based training in LCBDE would result in increased utilization and improve patient outcomes across participating institutions.

methodsData was obtained from an on-going multi-center study in which simulator-based transcystic LCBDE training curricula were instituted for attending surgeons and residents. A 2-year retrospective review of LCBDE utilization prior to LCBDE training was compared to utilization up to 2 years after initiation of training. Patient outcomes were analyzed between LCBDE strategy and ERCP strategy groups using χ

resultsA total of 50 attendings and 70 residents trained in LCBDE since November 2020. Initial LCBDE utilization rate ranged from 0.74 to 4.5%, and increased among all institutions after training, ranging from 9.3 to 41.4% of cases. There were 393 choledocholithiasis patients analyzed using LCBDE (N = 129) and ERCP (N = 264) strategies. The LCBDE group had shorter median LOS (3 days vs. 4 days, p < 0.0001). No significant differences in readmission rates between LCBDE and ERCP groups (4.7% vs. 7.2%, p = 0.33), or in post-procedure pancreatitis (0.8% v 0.8%, p > 0.98). In comparison to LCBDE, the ERCP group had higher rates of bile duct injury (0% v 3.8%, p = 0.034) and fluid collections requiring intervention (0.8% v 6.8%, p < 0.009) secondary to cholecystectomy complications. Laparoscopic antegrade balloon sphincteroplasty had the highest technical success rate (87%), followed by choledochoscopic techniques (64%).

conclusionSimulator-based training in LCBDE results in higher utilization rates, shorter LOS, and comparable safety to ERCP plus cholecystectomy. Therefore, implementation of LCBDE training is strongly recommended to optimize healthcare utilization and management of patients with choledocholithiasis.

Indexed as

Cholecystectomy, LaparoscopicCholedocholithiasisLaparoscopyCholangiopancreatography, Endoscopic RetrogradeCommon Bile DuctHumansLength of StayRetrospective StudiesCholedocholithiasisCholedochoscopeCommon bile duct explorationCurriculumSimulation-based education

Identifiers

PMID37910247
OpenAlexW4388141914

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.