title: Contemporary outcomes of ambulatory laparoscopic cholecystectomy in a major teaching hospital.
abstract: Ambulatory laparoscopic cholecystectomy is an established practice in our institution, with an experience of more than 800 cases. The present study is conducted to evaluate the contemporary outcomes of day-case laparoscopic cholecystectomy in the setting of a major teaching hospital. A retrospective analysis of 200 patients who underwent ambulatory laparoscopic cholecystectomies was performed to evaluate the postoperative morbidity, unplanned admission, and readmission rates. Causes for unanticipated admission and readmission were analyzed. Uneventful recovery was attained in 185 (92.5%) patients. The mean length of the operation was 56 +/- 20 (SD) minutes. There was no hospital mortality, and no patient required conversion to open cholecystectomy. Nine patients were admitted overnight after operation because of nausea and vomiting (n = 3), pain (n = 2), urinary retention (n = 2), medical observation n = 1), and patient's preference (n = 1), leading to an unanticipated admission rate of 4.5%. Six patients required readmission because of postoperative complications (n = 4) and abdominal pain (n = 2), giving a readmission rate of 3%. The overall postoperative morbidity rate was 3% (n = 6), including retained stones n = 4), bile leakage (n = 1), and hepatic subcapsular hematoma (n = 1). Ambulatory laparoscopic cholecystectomy is a safe practice in appropriately selected patients. Postoperative nausea and vomiting was the commonest reason for unanticipated admission after operation, and retained stones was the most frequent postoperative morbidity necessitating readmission.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, Massachusetts 02115, USA.
authors.forename: Hung
authors.initials: H
authors.lastname: Lau
authors.forename: David C
authors.initials: DC
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome