title: Day Care Laparoscopic Cholecystectomy: Next Standard of Care for Gall Stone Disease.
abstract: BACKGROUND
  To access the feasibility, safety and success of day care laparoscopic cholecystectomy in a tertiary center in India.
  
  
  METHODS
  This is a retrospective analysis of prospectively collected data between 2004 and 2009 from a tertiary center in north India. All patients of symptomatic gallstone diseases having age less than 70 years, American Society of Anesthesiologists (ASA) grade I and grade II, living within 20 Kilometers of the hospital, availability of a responsible adult care taker at home, access to a telephone and a means of transportation to hospital if needed, underwent laparoscopic cholecystectomy under the care of the two participating surgeons, were considered for day care laparoscopic cholecystectomy. Clinical and operative data were recorded prospectively. All patients were discharged 6 to 8 hours after surgery with the advice to contact the surgical team over phone whenever necessary or on the day after discharge.
  
  
  RESULTS
  A total of 602 laparoscopic cholecystectomies were performed over a period of 6years, among them 309 (51.32%) were operated on day care basis. Nine patients in day care procedure group had conversion to open procedure (5 due to distorted anatomy of calot's triangle, 2 due to common bile duct stones, 1 due to bile duct injury and 1 due to bleeding from cystic artery stump). One patient had myocardial infarction and 3 had nausea and vomiting which failed to resolve by intravenous ondensteron and all these (13) patients (4.20%) needed unplanned admission to the hospital. Two hundred and ninety-six patients (95.79%) were discharged on same day.
  
  
  CONCLUSIONS
  In conclusion day care laparoscopic cholecystectomy is feasible, safe and equally effective in selected patients in Indian setup.
authors.affiliation: General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Lileswar
authors.initials: L
authors.lastname: Kaman
authors.affiliation: General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Javid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: General Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ishwar
authors.initials: I
authors.lastname: Bukhal
authors.affiliation: General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Divya
authors.initials: D
authors.lastname: Dahiya
authors.affiliation: General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rajinder
authors.initials: R
authors.lastname: Singh
keywords: Daycare surgery; Gallbladder; Laparoscopic cholecystectomy; Postoperative nausea and vomiting