Analysis of safety and economic benefit of 5 771 patients undergoing day surgery laparoscopic cholecystectomy

Abstract

Objective To explore the safety and economic benefits of day surgery laparoscopic cholecystectomy (LC/DS). Methods Clinical data of 5 771 patients undergoing LC/DS and 2 450 undergoing conventional laparoscopic cholecystectomy (CLC) in PLA General Hospital from November 2009 to January 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. In LC/DS group, there were 2 204 males and 3 567 females with the average age of (51±13) years old. In CLC group, there were 992 males and 1 458 females with the average age of (51±13) years old. The hospitalization time and total medical expenses of two groups were compared by Mann-Whitney test. The ratio of conversion to laparotomy, postoperative complication, postoperative 24-hour discharge rate, and 30-day readmission rate were compared by Chi-square test. Results The ratio of conversion to laparotomy and 30-day readmission rate was respectively 0.36%, 0.49% in LC/DS group and 0.16%, 0.49% in CLC group, and no significant difference were observed (χ2=2.83, 0.00; P>0.05). The postoperative 24-hour discharge rate in LC/DS Group was 83.34%, significantly higher than 49.22% in CLC group (χ2=1 020.30, P<0.05). The postoperative complication rate in LC/DS group was 6.59%, significantly lower than 14.56% in CLC group (χ2=130.19, P<0.05). The hospitalization time and total medical expenses in LC/DS group was respectively [3.0(1.0-33.0)] d and [0.98(0.56-4.59)] million RMB, significantly lower than [5.0(1.0-36.0)] d and [1.40(0.38-2.95)] million RMB in CLC group (Z=-17.33,-45.40; P<0.05). Conclusions LC/DS is safe and effective. It can reduce the incidence of postoperative complications, shorten the hospitalization time and reduce the hospitalization cost of patients. Key words: Cholecystectomy, laparoscopic; Safety; Economics, medical