Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Nov 27, 2026; 18(11): 126888
Published online Nov 27, 2026. doi: 10.4240/wjgs.126888
Published online Nov 27, 2026. doi: 10.4240/wjgs.126888
Self-reported open cholecystectomy training, practice, and confidence in the laparoscopic era: An international convenience-sample survey
Marcelo A F Ribeiro Jr, Rafael Dib Possiedi, Steven B Holsten, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Matthew Smith, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Yu-Hao Wang, Chien-Hung Liao, Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Author contributions: Ribeiro MAF Jr designed the research study, developed the survey instrument and coordinated data dissemination and collection, supervised the project and is the guarantor of the work; Ribeiro MAF Jr and Dib Possiedi R curated the data and wrote the first draft of the manuscript; Smith M contributed to the methodology and prepared the figures; Wang YH and Liao CH performed the formal analysis and contributed to data curation; Holsten SB contributed to the interpretation of the data and to the drafting of the manuscript; all authors critically revised the manuscript for important intellectual content, have read and approved the final version, and meet the ICMJE criteria for authorship.
AI contribution statement: The authors used Claude (Anthropic; Claude Sonnet and Claude Opus, 2025-2026) as an assistive technology during manuscript preparation. Its use was limited to language editing and refinement of American English usage, improvement of clarity and readability, assistance with drafting and restructuring text based on content and data supplied by the authors, formatting of the manuscript, tables and reference list to the journal’s style, and preparation of the point-by-point response to reviewers. No AI tool was used to generate the research question or study hypotheses, to design the survey instrument, to collect, generate or manipulate data, to perform any statistical analysis, or to interpret the findings or formulate the scientific conclusions; all analyses were performed in R by the authors with independent statistical consultancy support, and all interpretation and conclusions are the authors’ own. Every AI-assisted output was reviewed, verified and validated by the authors. The authors agree to accountability for all content of this manuscript and take full responsibility for its accuracy, integrity, originality and scientific validity. No AI tool is listed as an author or co-author.
Institutional review board statement: The study protocol was reviewed by the Institutional Review Board of the University of Maryland, Baltimore, and determined to be exempt under 45 CFR 46.104(d), category 2 (approval No. HP-00118360; Federal Wide Assurance FWA00007145; determination dated April 9, 2026). The study was conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Participation was voluntary and anonymous. Respondents were informed of the purpose of the study on the survey landing page and provided electronic informed consent before accessing the questionnaire. No personally identifiable information and no patient data were collected.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The de-identified dataset analyzed in this study is available from the corresponding author on reasonable request.
Corresponding author: Marcelo A F Ribeiro Jr, MD, PhD, FACS, Professor, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, United States. drmribeiro@gmail.com
Received: August 17, 2026
Revised: September 3, 2026
Accepted: October 21, 2026
Published online: November 27, 2026
Processing time: 89 Days and 6.5 Hours
Revised: September 3, 2026
Accepted: October 21, 2026
Published online: November 27, 2026
Processing time: 89 Days and 6.5 Hours
Core Tip
Core Tip: Among 391 self-selected respondents to an internationally disseminated survey, laparoscopic and open cholecystectomy exposure diverged sharply: Two thirds reported more than 100 laparoscopic cases as primary surgeon, but only about one third reported the same for the open operation and nearly one in three reported ten or fewer. Only one in five had ever undergone standardized skills assessment and one in six had received simulation training for emergency conversion. Self-reported confidence remained high for routine steps but fell for common bile duct exploration and for repair of bile duct injury, the scenarios in which open biliary competence actually matters. Because the sample was self-selected and confidence is not competence, these findings are descriptive and hypothesis-generating.