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[Laparoscopic cholecystectomy as an outpatient procedure]
Henrik Loft Jakobsen1, Ismail Gögenur, Bo Jacobsen
1Amtssygehuset i Gentofte, Kirurgisk Gastroenterologisk Afdeling D. hloft@dadlnet.dk
Introduction:
The aim of this study was to describe our experience with laparoscopic cholecystectomy as an outpatient procedure in terms of complications, same-day discharge, and a registration of patient' postoperative pain, convalescence and contact with general practitioners.
Materials And Methods:
A prospective evaluation was done of the first 231 patients undergoing laparoscopic cholecystectomy in an outpatient clinic.
Results:
Ninety per cent of the patients were discharged directly from the outpatient clinic, and a total of 93% of the patients were discharged within 24 hours of the operation. The readmission rate was 1%. Leakage from the cystic duct occurred in one case (0.4%), and no other injuries to the bile ducts were observed. The conversion rate was 1%. Within a week 54% of the patients had no pain and 55% of the patients had resumed normal activity. Postoperatively, 25% of the patients had contact with a general practitioner due to wound and other complaints that required no intervention.
Discussion:
Laparoscopic cholecystectomy is very suitable as an outpatient procedure due to its high same-day discharge rate and high patient satisfaction combined with low readmission and complication rates. Our study did expose, however, a high number of postoperative contacts with general practitioners due to non-surgical problems, which emphasizes the need for better patient information and cooperation with general practitioners to optimize the outpatient procedure further.
