Day Care Laparoscopic Cholecystectomy: A Study of Feasibility and Safety in Qatar

Abstract

Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic gall bladder disease and is one of the most frequently performed operations in Qatar. Daycare laparoscopic cholecystectomy (DCLC) was started in 2003 offering many advantages over conventional laparoscopy including reduced demand for hospital beds. DCLC has been shown to be safe in many centers worldwide but in Qatar its feasibility and safety had not been studied. During the 24 months July 2003-July 2005 fifty-six cases of DCLC were studied. Inclusion criteria were aged less than 60years, Grade 1 and 2 anesthesia risk according to American Society of Anesthesiology (ASA), living within an hour's drive of the hospital, had telephone access, living with a responsible adult, capable of reaching the hospital with or without depending on emergency medical services (EMS), able to understand discharge instructions, agreeing to participate by informed consent and the presence of symptomatic gall bladder disease. Complicated cases were excluded. The success rate of DCLC (same day discharge) was 48/56 (86%), most patients being observed in the Daycare Unit (DCU)for 6-8 hours. Pain,post-operative nausea and vomiting (PONV) were the most common causes of failure. There were no re-admissions within 30 days of surgery. Complications were minor and most patients were highly satisfied with same day discharge from the hospital. We conclude that DCLC is safe, feasible and has potential benefits for the health care system in Qatar.Surgeons performing laparoscopic cholecystectomy should recognize the advantages of DCLC and offer this approach to their patients in uncomplicated cases