Laparoscopic Cholecystectomy in Day Surgery

Abstract

Laparoscopic cholecystectomy (LC) has now become the “gold standard” treatment for symptomatic gallstone disease. Thanks to its advantages (i.e., smaller scars, reduced postoperative pain), patients enjoyed a shorter hospital stay and consequently, many healthcare providers have started to explore the feasibility of offering LC as a day-case procedure, and in 1990 some authors had already reported the first experiences of ambulatory surgery. Nowadays day-case LC (DLC) has been adopted with different rates and it is not fully accepted by all surgeons. The main question concerns whether the DLC might be feasible for all or just for selected cases. It is common opinion that DLC is indicated for selected cases and the selection may concern medical and logistic criteria. Some exclusion criteria may be considered advisable: common bile duct stones, acute cholecystitis, pancreatitis, patient’s age, and intraoperative complications. Some authors pointed out the importance of anesthesia and postoperative control of pain, nausea, and vomiting as strongly needed elements to allow patients’ early discharge. In conclusion DLC seems to be a safe and effective intervention in selected patients (with no or minimal systemic disease and within easy reach of the hospital) with symptomatic gallstones.