Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit?
OBJECTIVE
Analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance.


METHODS
Eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service) from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients.


RESULTS
Group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017), inability to tolerate oral diet (p = 0.002), and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003).


CONCLUSIONS
Outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.
Service of General Surgery and Digestive Diseases, University Hospital Virgen del Rocío, Sevilla, Spain. almulaciru@hotmail.com
A
A
Martínez Vieira
F
F
Docobo Durántez
J
J
Mena Robles
I
I
Durán Ferreras
J
J
Vázquez Monchul
F
F
López Bernal
E
E
Romero Vargas
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D013531:Surgicenters / Q000706:statistics & numerical data; D016896:Treatment Outcome