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[Ambulatory laparoscopic cholecystectomy. A cohort study of 1,600 consecutive cases]
Manuel Planells Roig1, Rafael Garcia Espinosa, María Cervera Delgado
1Instituto de Cirugía y Aparato Digestivo (ICAD), Clínica Quirón de Valencia, Valencia, España. planells_mvi@gva.es
Objective:
A descriptive analysis of day-case laparoscopic cholecystectomy (ALC) in a cohort of 1,600 consecutive patients performed in Instituto de Cirugía y Aparato Digestivo (ICAD), Clínica Quirón de Valencia in the period 1997-2010.
Patients And Methods:
Prospective observational study of 1,601 consecutive patients undergoing elective laparoscopic cholecystectomy (LC) provided by the regional health service and private health companies.
Main Measures:
Conversion rate, non-planned admissions, readmissions, surgery duration and demographics.
Results:
ALC was successfully performed in 80.8% of cases. LC with over-night (ON) stay accounted for 13.4% of patients. Admission was necessary in 4.6%. Mortality was 0.13%, 0.08 in ALC and 0.5% in ON LC. Readmissions occurred in 2.1%, 1.6% in ALC group, 5.4% in ON stay and 4.2% in admission group.
Conclusions:
ALC is a reliable and safe procedure. Minimization of admission rates is the key for cost-effective optimization in the management of cholelithiasis. ALC should be considered as the reference standard in gallbladder stone disease treatment.