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Predicting failure of outpatient laparoscopic cholecystectomy
Thomas N Robinson1, Walter L Biffl, Ernest E Moore
1Department of Surgery, Denver Health Medical Center/University of Colorado Health Sciences Center, USA.
Background:
Outpatient laparoscopic cholecystectomy (LC) is safe and feasible, but factors related to the failure of outpatient surgery are poorly defined. We hypothesized that patients in whom same day discharge (SDD) is unlikely may be identified preoperatively.
Methods:
Three hundred eighty-seven consecutive patients scheduled for elective LC were prospectively enrolled in an outpatient clinical pathway.
Results:
In all, 269 (70%) patients successfully underwent outpatient LC. Factors related to failure of SDD were age, American Society of Anesthesiology (ASA) class, surgery start time, and duration of surgery. Body mass index, liver function tests, and ultrasound findings did not predict failure of SDD. Three factors were able to predict more than 50% failure of SDD: age more than 50 years, ASA class 3 or more, and surgery start time later than 1:00 PM.
Conclusions:
Outpatient LC is feasible in a large county hospital. These data may be used in scheduling cases and counseling patients.