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Early feeding and discontinuation of intravenous fluid after laparoscopic cholecystectomy
J N Shah1, S B Maharjan, K Manandhar
1Department of Surgery, Patan Hospital, Patan Academy of Health Science, Lalitpur, Kathmandu, Nepal. drjaywufei@gmail.com
Insights
Early oral feeding and stopping intravenous fluids after laparoscopic cholecystectomy (LC) is safe and well-accepted. This approach offers economic benefits and supports fast patient recovery following the minimally invasive procedure.
Area of Science:
- Surgery
- Gastroenterology
- Clinical Medicine
Background:
- Standard practice involves prolonged intravenous fluid administration post-laparoscopic cholecystectomy (LC).
- This prolonged fluid management may be unnecessary due to rapid recovery after minimally invasive LC.
- The study investigated alternatives to current post-operative fluid management protocols.
Purpose of the Study:
- To assess the safety, acceptability, and benefits of early oral feeding post-LC.
- To evaluate the feasibility of discontinuing intravenous (i.v.) fluids sooner after LC.
- To observe patient outcomes with modified post-operative fluid management.
Main Methods:
- A prospective, cross-sectional observational study was conducted.
- Elective laparoscopic cholecystectomy patients were included.
- Oral liquids were initiated at 4 hours, and i.v. fluids were discontinued at 6 hours post-LC.
Main Results:
- 97% of 294 patients received oral fluids starting around 5.5 hours post-surgery.
- Intravenous fluids were continued in only 3% of patients.
- Postoperative nausea and vomiting occurred in 25.9%, with 6.6% requiring continued i.v. fluids; no adverse effects were noted from early i.v. discontinuation.
Conclusions:
- Early oral feeding and discontinuation of i.v. fluids after LC are safe.
- This practice is economical and well-accepted by patients, families, and nursing staff.
- The findings support a revised post-operative care protocol for LC patients.
Background:
Common practice at most centers in the country is to continue intravenous (i.v.) fluid till morning round next day following laparoscopic cholecystectomy (LC), assess patient and gradually allow oral diet. However this seems unnecessary in view of fast recovery after minimal invasive LC. The aim of this study was to observe the prospects and assess the acceptability, safety and benefit of early oral feeding and discontinuing i.v. fluid after LC.
Methods:
This cross-sectional observational study was carried out prospectively from Oct 1, 2009 to Sep 31, 2010 at Patan Hospital, a university teaching hospital. All elective LC patients were included. Oral liquid was introduced after four hours and i.v. fluid was stopped after six hr of LC. I.v. cannula was kept locked in situ. Vomiting, abdomen distension and reasons for continuation or resumption of i.v. fluids were recorded.
Results:
During one year period 294 LC patients fulfilled study criteria. Average age was 40.8 years. Female accounted for 78.2%. Oral fluid was started in average of 5.5 hrs in 97%. In 3% (9/294) i.v. was continued. Postoperative nausea and vomiting was observed in 25.9% (76/294), of which 6.6% (5/76) required i.v.. There was no untoward affect after i.v. fluid was stopped.
Conclusions:
Early oral feeding and discontinuing of intravenous fluid in laparoscopic cholecystectomy is safe, economic and well accepted by patients, family and nursing staff in Patan hospital.
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