Abstract

Abstract Aim

The introduction of laparoscopic cholecystectomy (LC) led to a notable increase in bile duct injury (BDI) rates, rising globally from 0.3% to 0.6%. Despite advancements, current rates persist at 0.2–0.3%. In the UK, BDI remains an indefensible complication. There has been no coordinated national effort to standardise safe LC training.

This study aimed to establish evidence-based criteria for the selection, content, structure, and delivery of the CholeSafe 1 course, a dedicated programme designed to teach standardised techniques for safer cholecystectomy and to reduce BDI incidence.
Method

A multisociety expert panel was formed, comprising consultant faculty and trainees from BBUGSS, AUGIS, the Roux Group, and GBIHPBA. A Delphi process was employed, with consensus defined a priori as ≥70% agreement. Two rounds of structured statements were administered to achieve a consensus of over 75% on key components.
Results

Nineteen faculty representatives participated in the first round and fourteen in the second. Statements that did not reach consensus were revised or removed before re-administration. By the end of the second round, consensus was achieved on several critical aspects: the appropriate level of trainee experience, complexity of cases suitable for teaching, prerequisite understanding of biliary anatomy and BDI implications, standardisation of operative steps and terminology, as well as the course’s overall structure, duration, and delivery format.
Conclusions

The first implementation of the CholeSafe 1 course is planned for the AUGIS Scientific Meeting in 2025. Feedback from this initial rollout will guide future refinements, supporting the broader aim of enhancing surgical safety in LC across the UK.