Laparoscopic cholecystectomy as a day surgery procedure: implementation and audit of 136 consecutive cases in a university hospital

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Ressource 1Download: serval:BIB_363BDD15F5F3.P001 (66.05 [Ko])
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Version: author
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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_363BDD15F5F3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Laparoscopic cholecystectomy as a day surgery procedure: implementation and audit of 136 consecutive cases in a university hospital
Journal
World Journal of Surgery
Author(s)
Vuilleumier  H., Halkic  N.
ISSN
0364-2313 (Print)
Publication state
Published
Issued date
2004
Volume
28
Number
8
Pages
737-740
Notes
DA - 20040930
LA - eng
PT - Comparative Study
PT - Journal Article
SB - IM
Abstract
Laparoscopic cholecystectomy (LC) has been routinely performed since 1989 at our institution, and patients were traditionally admitted for 2 days. In 1996 we implemented a protocol for LC as a day surgery procedure at our center. Although initially reported by others, it has not yet been introduced as routine in Switzerland. The objective of this prospective study was to determine acceptability and safety of LC as an outpatient procedure in a university hospital. Data were collected prospectively for 136 LCs between January 1996 and December 2001. Patients were selected for the study if they wanted to go home within less than 24 hours, had no previous jaundice, and had no anesthetic contraindication. Systematic preoperative liver function tests and hepatic ultrasonography were performed. All patients were admitted on the day of operation. LC was performed using a three-trocar technique. Systematic cholangiography was performed, and all the procedures were completed laparoscopically. There were no common bile duct explorations. Postoperative complications were the following: nausea in seven patients, a minor umbilical hematoma in two. According to patient preference, 101 (74%) were discharged after an overnight stay (less than 24 hours) and 32 (24%) on the same day. The unplanned admission rate was 2%, and none of the patients was subsequently readmitted. The reasons for unplanned admissions were two patients with persistent nausea and one patient for whom an overnight stay was scheduled who presented with a ruptured subcapsular hematoma of the liver. Altogether, 97% of the patients were satisfied with the care they received. Operative costs were not significantly different when comparing inpatient and outpatient LC. The main postoperative savings were in the postoperative costs. Our results confirm that LC as a day surgery procedure is safe, effective, and acceptable to patients and their relatives. These results were achieved by using selection criteria that considered not only the surgical pathology but also the individual and by using appropriate techniques and planned postoperative analgesia
Keywords
Adult/Aged/Ambulatory Surgical Procedures/economics/methods/Cholecystectomy,Laparoscopic/Cost Savings/statistics & numerical data/Female/Hospitals,University/Humans/Male/Medical Audit/Middle Aged/Outcome and Process Assessment (Health Care)/Patient Acceptance of Health Care/Patient Readmission/Postoperative Care/Postoperative Complications/etiology/Postoperative Nausea and Vomiting/Prospective Studies/Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
18/02/2008 13:08
Last modification date
01/10/2019 6:17
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