Ambulatory management of gastrointestinal emergencies: what are the current literature data?

Abstract

Introduction: Ambulatory management is a modality of care defined in France by a hospitalization of less than 12h without an overnight stay. Currently, few data are available on its role in the management of gastrointestinal emergencies, such as appendectomy for acute appendicitis, cholecystectomy for acute cholecystitis or emergency proctologic surgery. The aim of this systematic review was to study the published data regarding the feasibility of ambulatory management of emergency visceral surgery and to enquire about the possibilities of further development of this form of management.

Materials and methods: A literature search was conducted from the PubMed(®) databank taking into account all published data up to July 2013.

Results: For acute appendicitis, the success rate of short-stay hospitalization was 72% with unplanned read-mission rates ranging from 0 to 53%, a rate of unscheduled consultations ranging from 0 to 11%, and unplanned inpatient hospitalization rates ranging from 0% to 5%. For acute cholecystitis and proctology, there are few published data.

Conclusion: Ambulatory management has been sparingly studied in the setting of gastrointestinal surgical emergencies. However, there is probably a place for development of this form of management.

Keywords: Emergency; Gastrointestinal surgery; Outpatient management.