Outpatient Laparoscopic Cholecystectomy

Smith, Randall W.; Kolyn, D.; Pace, R. F.

doi:10.1155/1994/70629

Cited by 36 publications

(16 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 2 Evidence supporting safety of major DCS including laparoscopic cholecystectomy is predominantly composed of case series of selected patients. [3][4][5][6][7][8] Universal extrapolation of published experience is potentially dangerous because poor and unacceptable outcomes have been reported. 10 11 The risk may be even more in economically deprived countries where low literacy rates, lack of reliable and efficient transport, absence of organised referral patterns, poorly developed communication systems, underdeveloped primary health care services, and absence of community nursing have prevented the successful introduction of major surgical operations as day care surgery.…”

Section: Discussionmentioning

confidence: 99%

“…1 2 Several published studies have testified to the safety and feasibility of day care laparoscopic cholecystectomy (DCLC). [3][4][5][6][7][8] These reports, however, emanate from developed countries with well established norms for day care surgery with rigorously monitored outcomes. [3][4][5][6][7][8] The reported safety of laparoscopic cholecystectomy cannot therefore be universally extrapolated to surgical practice everywhere.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Feasibility and safety of day care laparoscopic cholecystectomy in a developing country

Bal

Reddy

Parshad

et al. 2003

Postgraduate Medical Journal

View full text Add to dashboard Cite

Background: Although day care laparoscopic cholecystectomy (DCLC) has been shown to be safe in centres with adequate infrastructure for day care surgery, its feasibility and safety in developing countries has never been studied. Because of differences in the quality of health care delivery, western guidelines for day care surgery cannot be universally applied to developing countries. Patients and methods: Patients less than 65 years who were graded I and II on the American Society of Anesthesiologists physical status score, irrespective of their educational status, living within 20 km, and willing to make their own arrangements for a return to hospital in case of problems were selected for DCLC. Follow up was done by patients calling the hospital the morning after surgery. Results: 50% of the eligibility criteria were new; 313/383 patients were suitable for DCLC. The commonest cause for rejection was that the patient lived out of the defined area (50%). Altogether 92% were discharged within eight hours of surgery. The reasons for failure to discharge were the presence of abdominal drains in four (2%), nausea and vomiting in nine (3%), and conversion to open surgery in five (2%). Ten patients (3%) were readmitted; of these only two (<1%) had complications needing re-exploration. Analysis of results showed that the inclusion and discharge criteria were valid and that the readmission and complication rates as well as the ease and accuracy of follow up were comparable to published data. DCLC reduced waiting times and increased patient turnover and may have a positive impact on resident training. Conclusions: DCLC is safe, feasible, and has potential benefits for health care delivery in developing countries. Each surgical service needs to develop their own guidelines based on local patient demography.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Feasibility and safety of day care laparoscopic cholecystectomy in a developing country

Bal

Reddy

Parshad

et al. 2003

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

“…A crucial aspect in the development of a safe Day Care program is the criteria for patient selection. Robinson"s et al [44] reported their experience in a public academic institution where they achieved outpatient laparoscopic cholecystectomy in 70% of unselected patients and they have identified ASA classification, procedural duration and surgery start time as a factor associated with failure of day care program. Some authors have come to the conclusion that appropriate patient selection lowers failure rate and patients most likely to fulfill the criteria of day care laparoscopic cholecystectomy are ASA grade I,II and younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…Comparision showing success, failure and readmission rates of various studies (table 9) Study Total patients Success rate(%) Failure rate(%) Readmission rate(%) Selim et al [58] 200 90% 10% 10% Taylor et al [40] 108 87% 13% na Robinson et al [44] 387 70% 30% na S.S. Bal et al [45] 313 92% 8% 3% Ibramin et al [46] 70 100% 0% 1.5% Chauhan et al [47] 287 96% 4% 3% Athar et al [54] 50 92% 8% 2% Kaman et al [60] 106 95% 5% na Present study 50 90% 10% 4%…”

Section: Discussionmentioning

confidence: 99%

Day Care Laproscopic Cholecystectomy – A Prospective Study

Singh¹

2017

IOSR JDMS

View full text Add to dashboard Cite

“…Prompt surgical management of confirmed symptomatic cholelithiasis is the standard of care and the treatment of choice, provided no contraindication exists [7]. Laparoscopic cholecystectomy has evolved as the gold standard and has been shown to reduce total hospital charges [10]. The untimely manner in which the standard treatment of symptomatic cholelithiasis is applied to MediCal patients is not equitable under the current system.…”

Section: Discussionmentioning

confidence: 99%

The complications of cholelithiasis caused by state authorization delays

Guirguis

Taylor

1995

Surg Endosc

View full text Add to dashboard Cite

The impact of delay in elective cholecystectomy caused by preoperative state authorization requirements was retrospectively studied. The Student's t-test was used for statistical analysis. From 10/92 to 5/94, 146 patients were evaluated in an outpatient surgery clinic and elective cholecystectomy was planned. These patients were divided into two groups. Group 1 (101) patients waited for state authorization prior to cholecystectomy while group 2 (45) patients did not need state authorization. Group 1 patients waited an average of 112 days from the time of diagnosis to the time of surgery while group 2 patients waited an average of 21 days (P < 0.001). Group 1 patients were more likely to develop acute complications of cholelithiasis and require admission and urgent cholecystectomy than group 2 patients (22% vs 11%, P < 0.05). Group 1 patients requiring emergent treatment were found to have a longer hospital stay (P < 0.001), longer operative time (P < 0.05), and higher intraoperative blood loss (P < 0.005) than group 1 elective cases. Elective cholecystectomy patients who require state authorization have to wait longer prior to cholecystectomy and frequently develop acute complications of cholelithiasis requiring hospital admission and nonelective surgery. This translates into increased patient morbidity and added cost. State authorization requirements act as a barrier to providing timely care, add to cost, and must be considered in the current deliberations on health care policy.

show abstract

Outpatient Laparoscopic Cholecystectomy

Cited by 36 publications

References 1 publication

Feasibility and safety of day care laparoscopic cholecystectomy in a developing country

Feasibility and safety of day care laparoscopic cholecystectomy in a developing country

Day Care Laproscopic Cholecystectomy – A Prospective Study

The complications of cholelithiasis caused by state authorization delays

Contact Info

Product

Resources

About