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Laparoscopy as a day-case procedure in patients with liver disease
G Unal1, H R van Buuren, R A de Man
1Dept. of Hepatogastroenterology, Rotterdam University Hospital, The Netherlands.
Background And Study Aims:
The present study was aimed at exploring the feasibility of diagnostic laparoscopy on a day-case basis in patients with liver disease.
Patients And Methods:
Retrospective analysis was carried out of 85 consecutive day-case laparoscopies performed between January 1990 and January 1994. During this period, patients were observed in day-care facilities for a period of three hours. Patients' perception and acceptance of the procedure were assessed using a postal questionnaire.
Results:
Laparoscopy was successful in 84 of the 85 patients; adequate liver biopsies were obtained in 83 patients. In three cases, the procedure was converted to a one-night hospital admission because of pain (1), persistent sedation (1) and collapse (1). Abdominal skin hematomas were reported by eight patients, and fever by two. Serious complications were not observed. The majority of patients experienced no complaints, or minor ones, after the procedure, and they expressed a preference for an outpatient procedure in case a renewed investigation might be indicated. Compared with in-hospital procedures, day-case laparoscopy was associated with a 33% reduction in cost.
Conclusions:
Diagnostic laparoscopy, with the hospital stay reduced to three hours, can be performed safely as a day-case procedure in selected patients.