Can laparoscopic cholecystectomy be a day surgery procedure?
OBJECTIVE
Gallbladder surgery by videolaparoscopy (VL) is now able to obtain the same goals as traditional surgery, and is associated with comparable or better results both in terms of positive surgical outcome and patient satisfaction. With public health spending under growing social and administrative pressure, and continuous efforts focusing on enhancing the efficiency of both surgical instruments and operating procedures, it is a most attractive, albeit initially challenging, prospect to regard video-laparoscopic surgery as day-case surgery. Herein, the authors assess the outpatient treatment option, due to recent technical developments and relevant major organizational and professional implications, and consider the feasibility of day-case surgery projects which should soon be implemented.


METHODS
From January 1994 to December 1996, 1,334 patients underwent videolaparoscopic cholecystectomy. Of these, 898 were women and 436 men. In 1,034 of the laparoscopies gas was used and 300 were performed without gas. Out of the total 1,334 patients who were submitted to the videolaparoscopic cholecystectomy procedure with or without the use of gas, 72 (5.4%) were treated on an outpatient basis.


RESULTS
In our series, 93.5% of patients reported normal post-operative functions within 24 hours; 90.2% of patients were able to take oral fluid on the same day of the operation and had normal bowel peristalsis within the first post-operative day.


CONCLUSIONS
The authors assess the outpatient option treatment, due to recent technical developments and relevant major organizational and professional implications, and consider the feasibility of a day-case surgery project which should soon be implemented.
Campanelli
G
G
University of Milan, Department of General and Thoracic Surgery, Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.
Cavagnoli
R
R
Cioffi
U
U
De Simone
M
M
Fabbiani
M
M
Pietri
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies