Laparoscopic cholecystectomy in a freestanding outpatient surgery center.
Laparoscopic cholecystectomy in a freestanding outpatient surgery center was evaluated. Fifty-five patients undergoing laparoscopic cholecystectomy during a 10-month period from December 1992 to October 1993 were included in this study. There were 10 males and 45 females, with a mean age of 42 years. All patients had a history consistent with biliary colic. Forty-nine patients had documentation of cholelithiasis by ultrasonography, 3 had documentation of cholelithiasis by other diagnostic procedures, and 3 had a diagnosis of biliary dyskinesia. The mean surgery time was 75 min, with a range of 43-145 min. Fifty-four intraoperative cholangiography attempts were made, and 81% were successful. In 19%, intraoperative cholangiography was unsuccessful secondary to a small cystic duct. Fifty of the patients (90%) in this study were discharged from the surgery center without significant sequelae. Four patients were admitted to the hospital postoperatively, 1 for bradycardia, 1 for nausea, 1 for i.v. antibiotics secondary to purulent cholecystitis, and 1 for inability to maintain an adequate oxygen saturation. Another patient was admitted 1 week postoperatively for right upper quadrant pain. After a negative hepatobiliary scan, this patient was discharged without sequelae. The average facility charge of laparoscopic cholecystectomy in this series was $2300, compared with the average charge of $6500 in our community hospital. We conclude that laparoscopic cholecystectomy can be performed safely and cost effectively in a freestanding outpatient surgery center with proper patient selection.
Department of Surgery University of Kansas School of Medicine-Wichita.
G J
GJ
Farha
B P
BP
Green
R L
RL
Beamer
D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures; D001660:Biliary Tract Diseases / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection