Feasibility and safety of day-surgery laparoscopic cholecystectomy: a single-institution 5-year experience of 1140 cases

Abstract

Backgrounds/AimsWe report our experience with day-surgery laparoscopic cholecystectomy and assess its feasibility and safety.MethodsData was collected on all the patients who underwent day-surgery laparoscopic cholecystectomy between February 2009 and February 2014 at Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. All patients had symptomatic cholelithiasis that was proven on imaging studies with clearance of the common bile duct. The patient biographical data (age, gender, American Society of Anaesthesiology status, medical comorbidities) and surgical outcomes were then obtained. There was an evaluation of the success rate of day-surgery laparoscopic cholecystectomy, reasons for unexpected admission, and the re-admission rate.ResultsA total of 1,140 patients were included in this study. The success rate for day-surgery laparoscopic cholecystectomy was 96%. The reasons for unexpected hospital admission for 46 patients (4%) included persistent abdominal pain and postoperative emesis. The postoperative re-admission rate was 0.4% (5 patients). There were no major complications, and the conversion rate was 0.5% (6 patients).ConclusionsWe suggest that day-surgery laparoscopic cholecystectomy is both safe and feasible in a local setting. Careful patient selection is essential in ensuring a high success rate.

Unanticipated Hospital Admission after Outpatient Laparoscopic Cholecystectomy

“…In the present study 16% of the patients scheduled for outpatient LC were not discharged after surgery as planned, which is comparable to the findings in other studies [1,7,10]. However, 21% of thesemainly staying in hospital due to excessive pain or PONV that could be controlled within a few hours -were discharged later on the same day.…”

“…The majority were treated conservatively with few episodes of major complications needing intervention such as laparoscopic re-surgery or stone extraction with ERCP. The results are comparable to those found in other studies [1,4,7,8,13]. Boehme et al [6] have looked into the relation between co-morbidity and postoperative resource utilization after LC and OC finding that certain comorbid conditions significantly increase utilization of postoperative resources including readmissions.…”

“…Since the first laparoscopic cholecystectomy (LC) was performed in 1985 this operation has become widely accepted and is now the standard operation for surgical treatment of symptomatic cholelithiasis [1]. The LC patients have a shorter hospital stay and less pain postoperatively compared to patients treated with open cholecystectomy (OC) [2].…”

Laparoscopic cholecystectomy as a day surgery operation: two centers experience.

“…Improvements in anaesthetics and increased surgeons laparoscopic experience have encouraged surgeons to perform LC as an elective outpatient procedure with only a few hours' hospital stay post-surgery. Many studies and literature reported the effectiveness and safety of ambulatory LC in selected patients, with reduced cost and high level of patient satisfaction [12][13][14][15][16][17].…”

Laparoscopic cholecystectomy in short-stay hospital

“…В последние годы в литературе встречаются публикации о выполнении лапароскопической хо-лецистэктомии (ЛХЭ) в условиях центров амбула-торной хирургии или стационаров одного дня [1][2][3][4][5].Основными преимуществами такого варианта лечения являются сокращение времени ожидания плановой операции, исключение риска развития го-спитальной инфекции, ускорение восстановления пациента за счет пребывания в домашних условиях, сокращение стоимости лечения, обследование, ле-чение и наблюдение за пациентом осуществляется одним врачом [6].Общее число послеоперационных осложнений (кровотечение, раневые осложнения) при выполне- Введение. в отечественной литературе сообщения о выполнении лапароскопической холецистэктомии (ЛХЭ) в амбула-торных условиях единичны.…”