[Outpatient laparoscopic cholecystectomy].
OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY: The laparoscopic technique is the procedure of choice for cholecystectomy. This procedure is done on ambulatory setting in the United States and Europe but no experience was reported in France.


OBJECTIVE
To report the organisation and results of our initial 100 consecutive patients operated for a laparoscopic cholecystectomy on an outpatient basis.


METHODS
After assessment of the prevention of pain and nausea or vomiting after laparoscopic cholecystectomy on hospitalized patients, a prospective trial was done on our first 100 patients for outpatient laparoscopic cholecystectomy on routine basis.


RESULTS
During the period, 27.4% of patients were entered on an ambulatory basis. 72% of patients did not need any medication post-operatively in the structure. 17 patients were admitted: in five cases, decision was done pre-operatively, one patient went back home against medical advising; in three cases, peroperatively, and in 10 cases postoperatively. Four patients were readmitted between the fifth and sixteenth post-operatoire day.


CONCLUSIONS
An adequate organisation for day case surgery, a good selection of patients on medical, surgical and environmental criteria, simple procedures to prevent pain or nausea vomiting post-operatively allow use to assert that hospitalisation is unjustified for laparoscopic cholecystectomy in a quater of patients.
Johanet
H
H
Clinique Sainte-Marie, 16, rue Eric-de-Martimprey, 95300 Pontoise, France. hubert.johanet@bch.ap-hop-paris.fr
Laubreau
C
C
Barei
R
R
Descout
F
F
Foulon
J P
JP
Tixier
V
V
D000328:Adult; D002763:Cholecystectomy / Q000191:economics / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D003363:Cost Control; D005260:Female; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000517:prevention & control; D010045:Outpatients; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010359:Patient Readmission; D018579:Patient Selection; D011183:Postoperative Complications; D011446:Prospective Studies; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control