Outpatient laparoscopic cholecystectomy: A new gold standard for cholecystectomy?

• Published in: Revista española de enfermedades digestivas Vol. 98; no. 1; pp. 14 - 24
• Main Authors: J. Bueno Lledó, M. Planells Roig, C. Arnau Bertomeu, A. Sanahuja Santafé, M. Oviedo Bravo, R. García Espinosa, R. Martí Obiol, A. Espí Salinas
• Format: Journal Article
• Language: English
• Published: Aran Ediciones
• Subjects: cirugía ambulatoria; colecistectomía laparoscópica; colelitiasis
• ISSN: 1130-0108

Objective: to contribute our experience for five years in the implemetation of outpatient laparoscopic cholecystectomy (LC). Patients: between January 1999 and March 2004 we performed 504 outpatient LCs. We applied both exclusion and inclusion criteria, an anesthetic and surgical protocol, and discharge-specific criteria. Postoperative management in "fast track" regime. Postoperative period controlled by protocol, including phone calls after cholecystectomy. Results: the ambulatory percentage in the global series was 88.8%, and mean hospital stay was 6.1 hours. Fifty-one patients required overnight stays (10.1%), most of them for "social" causes. Five patients required admission (between 24 and 48 hours) for different causes (conversion to laparotomy, intraoperative neumothorax, and postoperative medical complications). Six patients (1.1%) were readmitted, and we observed 11.6% postoperative complications in the global series, with abdominal parietal pain being most frequent. Phone localization by 22.00 p.m. in the same day of surgery was 100% complete for outpatient cases. Postoperative surveillance within the first month after surgery was completed in 93.9%, and within th first year in 86.7% of patients. Conclusions: outpatient LC is safe and feasible, and probably represents a new "gold standard" in the treatment of symptomatic cholelithiasis.