Outpatient versus inpatient laparoscopic cholecystectomy: a prospective randomized study of symptom occurrence, symptom distress and general state of health during the first post-operative week.
BACKGROUND
Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative symptoms, amount of distress, level of anxiety and general state of health during the first post-operative week.


METHODS
One hundred patients were randomized. Seventy-three LC patients were valid for efficacy (OPS n=34, IPS n=39). Data were collected by means of questionnaires.


RESULTS
The main result was that only minor [corrected] differences were seen between the groups regarding the occurrence of post-operative symptoms or symptom distress. Approximately 90% of the patients in both groups perceived pain, reduced mobility and tiredness on day 1. Nausea and loss of appetite were reported by half of the patients. Post-operative day 1, both groups reported much or very much distress related to pain and reduced mobility (approximately 40%) and nausea (approximately 20%). Although both groups reported less symptoms on day 7, one-third still experienced pain, but only one patient reported this to be distressing.


CONCLUSIONS
Laparoscopic cholecystectomy patients in both groups recover equally well, indicating that a greater proportion of LC patients should be offered the outpatient modality.
Barthelsson
Cajsa
C
Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet Stockholm, Sweden. cajsa.barthelsson@cfss.ki.se
Anderberg
Bo
B
Ramel
Stig
S
Björvell
Catrin
C
Giesecke
Kajsa
K
Nordström
Gun
G
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies