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

• Published in: Journal of evaluation in clinical practice Vol. 14; no. 4; pp. 577 - 584
• Main Authors: Barthelsson, Cajsa, Anderberg, Bo, Ramel, Stig, Björvell, Catrin, Giesecke, Kajsa, Nordström, Gun
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2008
• Subjects: Adult; Aged; Anxiety - epidemiology; Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - statistics & numerical data; cholesystectomy; day surgery; Female; gallstone disease; Health Status; Humans; Inpatients - statistics & numerical data; laparoscopy; Male; Medicin och hälsovetenskap; Middle Aged; Outpatients - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Period; Prospective Studies
• ISSN: 1356-1294; 1365-2753; 1365-2753
• DOI: 10.1111/j.1365-2753.2007.00920.x

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 no 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.
Conclusion  Laparoscopic cholecystectomy patients in both groups recover equally well, indicating that a greater proportion of LC patients should be offered the outpatient modality.