Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit?

Abstract

Objective: Analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance.

Patients and method: Eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service) from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients.

Results: Group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017), inability to tolerate oral diet (p = 0.002), and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003).

Conclusions: Outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.