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

Abstract

Background: Day-surgery, laparoscopic cholecystectomy (DSLC) becomes the standard management of chronic gall bladder diseases worldwide due to its safety and feasibility. The aim of our study was to assess DSLC at two secondary care governmental hospitals in Saudi Arabia with a separate day-surgery unit regarding complications, same-day discharge, to identify problems associated with the early discharge, and determine the degree of patient satisfaction. Methods: Over a 3-years period, all patients undergoing elective laparoscopic cholecystectomy under the authors were prospectively studied. All patients were asked on following up post-operatively about their satisfaction and recommendation of DSLC for their relatives and friends. Results: Eight hundred and sixteen patients underwent elective day surgery laparoscopic cholecystectomies, predominantly female (89.7%) and ASA I (77.2%) with a mean age 38.1 2 18.7 years. Eighty-eight percent of patients were discharged directly from the day surgery unit, and further 1.6% of patients (so nearly 89.6% of the patients) were discharged within 24 hours from the operation. Readmission following hospital discharges was necessary for three patients (0.37%). The overall rate of complications were 1.35% (11patients). At follow-up, 701 patients (97.36%) were satisfied with their experience undergoing DSLC. Conclusions: Our findings confirmed that DSLC is safe and feasible. Many patients showed high satisfaction with their length of stay and day surgery ward care although we extend the criteria for DSLC.

Laparoscopic Cholecystectomy in Acute Cholecystitis: Refining the Best Surgical Timing Through Network Meta-Analysis of Randomized Trials

“…Two studies defined early cholecystectomy when surgery was performed “≤7 days from symptoms.”12,14 Five studies defined as early those cholecystectomies performed within 24 hours from admission9,13,16,20,21 and in addition to these, 1 study defined early as within 24 hours from admission but after more than 72 from symptoms onset 23. These 6 studies were termed together as “≤24 hours from admission.” Five studies defined as early those cholecystectomies performed within 72 hours from admission10,11,17,25,26 and were termed as “≤72 hours from admission.” Finally, 7 studies defined early cholecystectomies as those performed within 72 hours from symptoms onset and were consequently termed as “≤72 hours from symptoms” 15,18,19,22,24,27,28. Details are provided in the Table 1.…”

“…23 These 6 studies were termed together as " ≤ 24 hours from admission." Five studies defined as early those cholecystectomies performed within 72 hours from admission 10,11,17,25,26 and were termed as " ≤ 72 hours from admission." Finally, 7 studies defined early cholecystectomies as those performed within 72 hours from symptoms onset and were consequently termed as " ≤ 72 hours from symptoms".…”

“…Seventeen studies used postponed cholecystectomy to about 6 to 8 or 6 to 12 weeks since admission/resolution of symptoms. 9,10,[12][13][14][15][17][18][19][20][21][23][24][25][26][27][28] These studies were termed together as "6-12 weeks from resolution." Two studies defined as delayed those cholecystectomies performed > 7 days from admission 11,16 and one study defined as those performed after 72 hours from symptoms.…”