[Outpatient laparoscopic cholecystectomy: initial results of a series of 200 cases].
BACKGROUND
Outpatient laparoscopic cholecystectomy (CL) has not been generalised due to the fear of complications by the surgeon and preference of patients for hospitalisation. This situation could be changed by setting up strict selection criteria and providing hospital home care. The aims of this study are to find out what percentage of our population fulfil these criteria, confirm their validity and find out if the surgical process should be improved before being introduced.


METHODS
A retrospective analysis was carried out on the first 200 elective CL cases dating from January 2006. The exclusion criteria were as follows: pre-operative criteria (social causes, age $ 70 years, unstable ASA III or ASA IV, an associated pathology or admission due to biliopancreatic patho-logy), intra-operative criteria (conversion, surgical time lasting longer than 90 minutes, non-identification or bleeding of the cystic artery, application of haemostatic material, haemorrhaging in the entrance ports, intra-abdominal bile spillage, drainage, difficulties in removing the gallbladder, anaesthetic and/or surgical complications) and post-operative (haemodynamic instability, excessive pain, nausea, and /or vomiting).


RESULTS
Out of the 200 cases, 53 (26.5%) patients fulfilled the criteria. The outpatient system was preferred predominantly by females and by those younger in age. Post-operative incidents occurred in 9.4% of the cases and these were dealt with by the hospital home care team.


CONCLUSIONS
Ambulatory CL procedure is safe. Patients of advanced age or with associated pathologies limit the inclusion. Hospital home care can solve any possible complications and contribute to the speedy discharge in those patients without criteria.
Martínez Ródenas
Francisco
F
Badalona Serveis Assistencials, Hospital Municipal, Badalona, Barcelona, España. fmartinez@bsa.gs
Hernández Borlán
Raquel
R
Guerrero de la Rosa
Yaima
Y
Moreno Solorzano
José
J
Alcaide Garriga
Ana
A
Pou Sanchís
Edmon
E
Torres Soberano
Gema
G
Vila Plana
José María
JM
Pie García
Jorge
J
Llopart López
José Ramón
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult