title: Timing of unplanned admission following daycare laparoscopic cholecystectomy.
abstract: BACKGROUND
  Outpatient laparoscopic cholecystectomy is the treatment of choice for symptomatic biliary colic. There is controversy regarding the optimal candidate, and postoperative observation time for patients receiving daycare laparoscopic cholecystectomy.
  
  
  METHODS
  A retrospective, multi-centred, case-control chart review was performed from January 1, 2009 to December 31, 2011 on consecutive patients undergoing planned laparoscopic cholecystectomy. Patient demographics, surgical details, and postoperative details were analyzed.
  
  
  RESULTS
  1256 daycare laparoscopic cholecystectomies were performed. One-hundred and twenty-one (9.6%) required unplanned admission the day of surgery. Forty (3.2%) were re-admitted within one month of surgery. The median time from surgical procedure to unplanned day of surgery admission was 218 min ± 143. The unplanned admission patients were older (54.6 vs 45.1, p < 0.005), and had ASA scores 3 or higher (24% vs 3%, p < 0.005). Comorbid conditions associated with unplanned admissions included hypertension, cardiac conditions, and chronic pain.
  
  
  CONCLUSIONS
  The majority of patients can be successfully managed with daycare laparoscopic cholecystectomy. A median time of 4 h is sufficient for postoperative observation. Risk factors for unplanned admission include age, ASA, hypertension, diabetes, and chronic pain.
authors.affiliation: University of British Columbia, Department of General Surgery, Vancouver, BC, Canada. Electronic address: nseyednejad@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Seyednejad
authors.affiliation: University of British Columbia, General/Trauma Surgery, Royal Columbian and Eagle Ridge Hospital, New Westminster, BC, Canada. Electronic address: Michelle.goecke@fraserhealth.ca.
authors.forename: M
authors.initials: M
authors.lastname: Goecke
authors.affiliation: University of British Columbia, General Surgery, Royal Columbian and Eagle Ridge Hospital, Fraser Health Authority, Department of General Surgery, New Westminster, BC, Canada. Electronic address: David.konkin@fraserhealth.ca.
authors.forename: D E
authors.initials: DE
authors.lastname: Konkin
mesh_terms: D000328:Adult; D000367:Age Factors; D000556:Ambulatory Surgical Procedures; D001955:British Columbia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D059350:Chronic Pain / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016055:Urinary Retention / Q000209:etiology
keywords: Daycare surgery; Laparoscopic cholecystectomy; Postoperative observation time; Unplanned admissions