Outpatient laparoscopic cholecystectomy feasibility

One-hundred nineteen elective cholecystectomies were performed at Kern Medical Center over a 20-month period from October 1992 to May 1994 and were retrospectively reviewed. Eight males and 111 females ranged in age from 16 to 70. Laparoscopic cholecystectomy was attempted in 116 patients and converted to open in 8 (7%). Of the elective procedures, 108 (91%) were planned as outpatient procedures. Of the 108 planned outpatient procedures, 73 (68%) were successfully completed as outpatients. Of the 35 patients who required unplanned admission, 21 were discharged in less than 24 h. In total, 101 (87%) of the 116 elective cholecystectomies begun laparoscopically were discharged in less than 24 h. Subsequent to this data analysis, our institution is developing a 23.9 h "day hospital" for postanesthesia observation. With extended postoperative monitoring and observation, patients with short-term problems such as nausea, vomiting, pain, and even patients with medical conditions requiring close observation and control should be able to avoid admission. This retrospective study indicates that with development of a 23.9 h postanesthesia care unit, the majority of elective cholecystectomies can be attempted and completed laparoscopically on an outpatient basis.