Predicting failure of outpatient laparoscopic cholecystectomy.
BACKGROUND
Outpatient laparoscopic cholecystectomy (LC) is safe and feasible, but factors related to the failure of outpatient surgery are poorly defined. We hypothesized that patients in whom same day discharge (SDD) is unlikely may be identified preoperatively.


METHODS
Three hundred eighty-seven consecutive patients scheduled for elective LC were prospectively enrolled in an outpatient clinical pathway.


RESULTS
In all, 269 (70%) patients successfully underwent outpatient LC. Factors related to failure of SDD were age, American Society of Anesthesiology (ASA) class, surgery start time, and duration of surgery. Body mass index, liver function tests, and ultrasound findings did not predict failure of SDD. Three factors were able to predict more than 50% failure of SDD: age more than 50 years, ASA class 3 or more, and surgery start time later than 1:00 PM.


CONCLUSIONS
Outpatient LC is feasible in a large county hospital. These data may be used in scheduling cases and counseling patients.
Robinson
Thomas N
TN
Department of Surgery, Denver Health Medical Center/University of Colorado Health Sciences Center, USA.
Biffl
Walter L
WL
Moore
Ernest E
EE
Heimbach
Julie K
JK
Calkins
Casey M
CM
Burch
Jon M
JM
D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data*; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D002769:Cholelithiasis / Q000601:surgery; D019091:Critical Pathways; D005260:Female; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure