Is laparoscopic cholecystectomy safe and acceptable as a day case procedure?
BACKGROUND
This study reviewed the results of performing day case laparoscopic cholecystectomy to assess the feasibility and safety of the procedure as a day case.


METHODS
This is a prospective study of 150 day case laparoscopic cholecystectomies performed between September 1999 and December 2004 under the care of the senior author. The results of a follow-up questionnaire to assess post-discharge clinical course and patient satisfaction were analyzed. All patients had commenced eating and drinking and were fully mobile before discharge home. The length of hospital stay was 4-8 hours.


RESULTS
The mean age of the patients was 43 years; 134 patients had an American Society of Anesthesiologists grade I, the remaining 16 patients were grade II. The mean operative time was 41 minutes. There were no conversions to open procedures. There was no bleeding, no visceral injury, and no mortality. There was one admission directly from the day surgical unit (admission rate of 0.6%), but no readmission following discharge. No patients were admitted due to postoperative nausea or pain. Ninety-nine (66%) of 150 patients responded to our questionnaire: 97% were satisfied about the information they had received. Patients rated their satisfaction with the procedure as follows: 75% excellent, 21% good, 3% satisfied, and 1 patient un-satisfied. Ninety-four percent of the patients would recommend the procedure as a day case.


CONCLUSIONS
Day case laparoscopic cholecystectomy is safe, feasible, and cost-effective when patients are carefully selected. It provides good patient satisfaction.
Kasem
Abdul
A
Princess Royal University Hospital, Farnborough Common, United Kingdom. abkasem@doctors.net.uk
Paix
Andrew
A
Grandy-Smith
Starlene
S
El-Hasani
Shamsi
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D003362:Cost-Benefit Analysis; D004326:Drinking; D004435:Eating; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics; D010351:Patient Discharge / Q000191:economics; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom