[Outpatient laparoscopic cholecystectomy. Experience in 357 patients].
BACKGROUND
Laparoscopic cholecystectomy (LC) is a widely used technique in the treatment of gallstone disease. Outpatient laparoscopic cholecystectomy (OLC) is a cost/effective and safe procedure in selected patients.


OBJECTIVE
A pilot program of OLC was conducted in a Chilean Public Hospital to evaluate the feasibility and results, including and patients' satisfaction using OLC.


METHODS
Patients were eligible for OLC if they were less than 60 years old, had low anesthestetitc risk (ASA I-II), normal liver function tests and an abdominal ultrasound showing gallstones or gallbladder polyps with a normal common bile duct.


RESULTS
We performed OLC in 357 patients aged 36 +/- 10 years, 90% female. Intraoperative complications were observed in 4 (1.1%) patients (uncontrolled bleeding in two and minor biliary tree injuries in two, both requiring conversion to the open technique). Four other patients required conversion due to anatomic reasons (overall conversion rate: 2.2%). Ninety two percent of patients were discharged within 6 hours of the operation. Eight (2.2%) were readmitted because of a mild acute pancreatitis (n=1), biliary leakage (n=1), persistent pain (n=2), vomiting (n=2), and retained stones (n=2). Two (0.6%) patients were re-operated. There was no mortality. Ninety-four percent of 277 patients (77.6%), who answered a Satisfaction Survey, evaluated OLC procedure with a high degree of satisfaction.


CONCLUSIONS
OLC is a safe and feasible procedure in selected gallstone patients. The procedure has good outcomes and a high degree of patient satisfaction. A wide use of OLC should reduce both direct and indirect costs of surgical treatment of gallstone disease.
Pattillo
Juan Carlos
JC
Servicio de Cirugía y Unidad de Cirugía Mayor Ambulatoria, Hospital Doctor Sótero del Río.
Kusanovic
Rodrigo
R
Salas
Patricio
P
Reyes
Julio
J
García-Huidobro
Ignacio
I
Sanhueza
Marcel
M
Palma
Alejandro
A
Báez
Sergio
S
Viñuela
Eduardo
E
Friant
Orlando
O
Galaz
Isabel
I
Silberman
Marcos
M
Arrese
Marco
M
Martínez
Jorge
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000592:standards*; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000592:standards*; D002769:Cholelithiasis / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011182:Postoperative Care; D011446:Prospective Studies; D013997:Time Factors
Colecistectomía laparoscópica ambulatoria: una experiencia factible en un hospital público chileno.