Changing trends in the management of gallstone disease.
BACKGROUND
Day case cholecystectomy is increasingly becoming a management option for elective cases while "same admission" cholecystectomy is now considered a favorable option in the treatment of acute cholecystitis. To assess the advent of these changes in our surgical practice, a retrospective analysis of our experience is presented.


METHODS
All patients undergoing cholecystectomy between January 2000 and January 2001 were analyzed according to admission status, operation type, conversion rate, complications, and nonsurgical intervention.


RESULTS
156 patients underwent cholecystectomy and 152 charts were retrieved. Laparoscopic cholecystectomy was performed on 95% of patients with a conversion rate of 9%. Morbidity for the series was 12.5%, including one common bile duct injury (0.6%). Day case and acute cholecystectomy comprised 67% of our cholecystectomy practice.


CONCLUSIONS
Our findings suggest that there is an increasing trend toward shortening the hospital stay of patients undergoing laparoscopic cholecystectomy. This does not appear to have had a deleterious effect on outcome.
Johnston
S M
SM
Department of Surgery, Adelaide and Meath Incorporating National Children's Hospital Tallaght, Dublin 24, Ireland. johnsts@tcd.ie
Kidney
S
S
Sweeney
K J
KJ
Zaki
A
A
Tanner
W A
WA
Keane
F V
FV
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D002763:Cholecystectomy / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D002769:Cholelithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000293:injuries; D017558:Elective Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007431:Intraoperative Complications; D007902:Length of Stay / Q000639:trends; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D013531:Surgicenters / Q000639:trends