TY - JOUR
T1 - Outpatient laparoscopic cholecystectomy
T2 - A prospective study on 250 patients
AU - Bona, Stefano
AU - Monzani, Roberta
AU - Fumagalli Romario, Uberto
AU - Zago, Mauro
AU - Mariani, Diego
AU - Rosati, Riccardo
PY - 2007/11
Y1 - 2007/11
N2 - Background - Patient selection, postoperative monitoring and discharge criteria after outpatient laparoscopic cholecystectomy (LC) are not clearly defined. Methods - Patients scheduled for elective LC who fulfilled socioeconomic requirements for ambulatory surgery were enrolled in an open prospective study. Choledocholithiasis, ASA IV and unstable ASA III patients were excluded. Discharge was allowed after at least 6 hours if patients were conscious, asymptomatic, ambulant, with normal vital signs, no evidence of bleeding, spontaneous micturition and tolerating soft diet. Results - Of the 250 patients included, 10.4% were admitted due to intraoperative causes. Of the remaining, 92% were discharged on the same day and 8.0% were admitted for pain control or post-operative anxiety/discomfort. Neither mortality or major complications were observed. Ninety-five percent of patients declared themselves satisfied. History of jaundice, common bile duct dilation on ultrasound, microlithiasis, abnormal preoperative alkaline phosphatase levels and surgeon's experience were independent predictors of admission due to intraoperative causes. No predictor of postoperative admission was identified. Cost analysis showed a benefit for ambulatory LC compared to overnight stay. Conclusion - Outpatient LC is feasible and safe with high patient satisfaction even with broad selection criteria. Improvements may be achieved in postoperative pain management.
AB - Background - Patient selection, postoperative monitoring and discharge criteria after outpatient laparoscopic cholecystectomy (LC) are not clearly defined. Methods - Patients scheduled for elective LC who fulfilled socioeconomic requirements for ambulatory surgery were enrolled in an open prospective study. Choledocholithiasis, ASA IV and unstable ASA III patients were excluded. Discharge was allowed after at least 6 hours if patients were conscious, asymptomatic, ambulant, with normal vital signs, no evidence of bleeding, spontaneous micturition and tolerating soft diet. Results - Of the 250 patients included, 10.4% were admitted due to intraoperative causes. Of the remaining, 92% were discharged on the same day and 8.0% were admitted for pain control or post-operative anxiety/discomfort. Neither mortality or major complications were observed. Ninety-five percent of patients declared themselves satisfied. History of jaundice, common bile duct dilation on ultrasound, microlithiasis, abnormal preoperative alkaline phosphatase levels and surgeon's experience were independent predictors of admission due to intraoperative causes. No predictor of postoperative admission was identified. Cost analysis showed a benefit for ambulatory LC compared to overnight stay. Conclusion - Outpatient LC is feasible and safe with high patient satisfaction even with broad selection criteria. Improvements may be achieved in postoperative pain management.
UR - http://www.scopus.com/inward/record.url?scp=38149057344&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38149057344&partnerID=8YFLogxK
U2 - 10.1016/S0399-8320(07)78322-7
DO - 10.1016/S0399-8320(07)78322-7
M3 - Article
C2 - 18166897
AN - SCOPUS:38149057344
VL - 31
SP - 1010
EP - 1015
JO - Clinics and Research in Hepatology and Gastroenterology
JF - Clinics and Research in Hepatology and Gastroenterology
SN - 2210-7401
IS - 11
ER -