[Laparoscopic cholecystectomy in day-surgery analysis of feasibility in 166 consecutive patients].
BACKGROUND
Day-Surgery (DS) is a widely spreading reality, both for clinical advantages to patients and organizational and economic profit to hospitals. In the last years, DS has been proposed for the treatment of a large number of diseases as inguinal and crural hernias, varicose vein, benign anorectal and thyroid pathologies. Recently, also laparoscopic cholecystectomy (LC) has been realised as DS procedure, and the initial results are promising.


OBJECTIVE
To determine both the clinical feasibility of LC in DS and the factors that can predict an extension of hospital stay.


METHODS
The present study is a retrospective analysis of 166 patients who underwent surgery because of symptomatic cholelithiasis in a three-year period; all patients underwent elective LC in ordinary hospital-stay. In order to identifying the patients potentially eligible for LC in DS, we carried on a selection by means of 3 consecutive stages: stage A, selection on the basis of preoperative data, stage B, selection on the basis of intraoperative factors and stage C, selection on the basis of postoperative parameters.


RESULTS
Out of 166 patients, only 33 (19,8%) would have been successfully treated in DS.


CONCLUSIONS
This study showed that LC in DS can be realised in strictly selected patients, on the basis of rigorous clinical and organizational criteria; furthermore, a continuous training of surgeons and nursing staff, the implementation of tele-medical facilities and the improvement of anesthesiological techniques will allow to the best results.
Nardi
M
M
Cattedra e Scuola di Specializzazione in Chirurgia Generate Università degli Studi di L'Aquila.
Perri
S G
SG
Gabbrielli
E
E
Felici
S
S
Nicita
A
A
Pietrangeli
E
E
Dalla Torre
A
A
Lotti
R
R
Moraldi
A
A
Citone
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies