Day case laparoscopic cholecystectomy carried out using the harmonic scalpel: analysis of a standard procedure.
BACKGROUND
Our aim was to determine the efficiency and safety of laparoscopic cholecystectomy carried out using the harmonic scalpel as a day case procedure.


METHODS
A prospective study was done on patients presenting for Laparoscopic cholecystectomy. The harmonic scalpel was used with retrograde dissection. All patients were considered for discharge the same day unless considered medically unfit.


RESULTS
Laparoscopic cholecystectomy using the harmonic scalpel was carried out on 100 patients. Major complications were as follows: conversion to open procedure -1%, common bile duct injury -1%, and bile leak from the cystic duct stump -1%. Our same day discharge rate was 65%, and age more than 65 was the only independent predictor of overnight admission (P=0.009).


CONCLUSIONS
Laparoscopic cholecystectomy using the harmonic scalpel is associated with a low complication rate and a high-same-day discharge rate when carried out as a day case procedure.
Patel
Sanjay Dhanji
SD
Newham University Hospital NHS Trust, Plaistow, London, UK.
Patel
Hemanshu
H
Ganapathi
Senthal
S
Marshall
Nichollas
N
D000704:Analysis of Variance; D001649:Bile Duct Diseases / Q000601:surgery / Q000628:therapy*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery / Q000628:therapy*; D003135:Common Bile Duct / Q000293:injuries / Q000601:surgery; D003549:Cystic Duct / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013525:Surgical Instruments; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D006113:United Kingdom