Relaxation of the criteria for day surgery laparoscopic cholecystectomy

For day case laparoscopic cholecystectomy programmes, studies suggest that overnight admission may be predicted by the following factors: gall bladder wall thickness, patient age over 55 years and previous sphincterotomy. This study investigated the effect of relaxing selection for a day surgery laparoscopic cholecystectomy programme, by removing these factors from the exclusion criteria.

Between September 2002 and April 2003, patients for elective laparoscopic cholecystectomy were considered for day surgery subject to standard criteria. For the initial part of the programme, patients were additionally excluded according to the risk factors mentioned above.

Thirty-three patients underwent intended day case procedures. The first 16 were selected according to the more rigorous criteria. The latter 17 were significantly older, with a significantly higher incidence of gall bladder wall thickening. There were seven admissions, three in the former part of the study and four in the latter.

The exclusion criteria described are not necessary for a good same-day discharge rate.