title: Outcome of a clinical pathway for discharge within 48 hours after laparoscopic gastric bypass.
abstract: BACKGROUND
  The benefits of laparoscopic gastric bypass (LGB) include decreased pain, quicker recovery, and shorter hospital stay. Our hypothesis was that a clinical pathway for 48-hour discharge after LGB can be implemented safely.
  
  
  METHODS
  Charts of patients undergoing LGB were retrospectively reviewed to assess our prospectively placed clinical pathway. Patients were discharged within 48 hours if they met the criteria of the pathway.
  
  
  RESULTS
  There were 104 patients who underwent LGB with no intraoperative conversions. Complications included 5 leaks, 5 reoperations, and no mortality. In our series, 76% (n=79) of patients were discharged within 48 hours. Gender and body mass index (BMI) did not differ between those who were discharged in 48 hours and those who were not (P=not significant). No patient who was discharged in 48 hours required return before their scheduled appointment.
  
  
  CONCLUSIONS
  A majority of patients after LGB can be discharged safely in 48 hours. A formal clinical pathway helps decrease hospital stay without adverse patient outcome.
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA. amadan@utmem.edu
authors.forename: Atul K
authors.initials: AK
authors.lastname: Madan
authors.forename: Karen E
authors.initials: KE
authors.lastname: Speck
authors.forename: Craig A
authors.initials: CA
authors.lastname: Ternovits
authors.forename: David S
authors.initials: DS
authors.lastname: Tichansky
mesh_terms: D000293:Adolescent; D000328:Adult; D019091:Critical Pathways; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010351:Patient Discharge; D012189:Retrospective Studies; D016896:Treatment Outcome