Abstract
Outpatient Laparoscopic Cholecystectomy was attempted in 98 patients selected from 266 patients presenting for elective cholecystectomy (37%). Two patients required admission following conversion to “open” Cholecystectomy, one patient was admitted for observation because of a technically difficult Laparoscopic Cholecystectomy and 16 patients were admitted because of refractory nausea and vomiting in the early post-operative period. Seventy-nine patients (81%) were able to be discharged home within 4 to 6 hours of surgery, with only one patient requiring readmission to hospital because of the onset of nausea and vomiting. There were no post-operative complications attributable to the outpatient experience. We believe this approach to elective gallbladder pathology can be safely accomplished in selected patients and will be increasingly utilized in the future.
Highlights
RESULTSCholecystectomy. 98 (37%) agreed to the outpatient approach at the time of the initial clinic visit
Outpatient Laparoscopic Cholecystectomy is certainly leasable, and we believe can be safely accomplished in selected patients
As we became comfortable with this approach, the percentage of patients having outpatient surgery increased so that 48% of our last 166 patients had an attempted outpatient Laparoscopic Cholecystectomy
Summary
Cholecystectomy. 98 (37%) agreed to the outpatient approach at the time of the initial clinic visit. 98 (37%) agreed to the outpatient approach at the time of the initial clinic visit. Outpatients were in general younger (mean age 40 years versus 52 years). Fewer outpatients had undergone previous abdominal surgery (38% versus 50%). This did not affect the operative technique in that almost all patients had successful pneumoperitoneum obtained with the veress needle Seventeen (17%) outpatients had acutely inflamed or fibrotic gallbladders. In comparison 53 (32%) inpatients had chronically scarred gallbladders. Two outpatients required conversion to "open cholecystectomy" while 14 inpatients required conversion. Operative time was similar in both groups (48 + 15 min for outpatients, 42 + 14 min for inpatients). Of the remaining 96 outpatients having a successful Laparoscopic. 133:35 (4:1) 20-87 yrs 52___16 yrs 83 (50%0) 159 (95%) 53 (32%) 14 (8%) 48_+15 min. 2.9_+2.3 days
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