Outpatient laparoscopic cholecystectomy: a new gold standard for cholecystectomy.

Autor:	Bueno Lledó J; Instituto de Cirugía General y del Aparato Digestivo, Valencia, Spain., Planells Roig M, Arnau Bertomeu C, Sanahuja Santafé A, Oviedo Bravo M, García Espinosa R, Martí Obiol R, Espí Salinas A
Jazyk:	English; Spanish; Castilian
Zdroj:	Revista espanola de enfermedades digestivas [Rev Esp Enferm Dig] 2006 Jan; Vol. 98 (1), pp. 14-24.
DOI:	10.4321/s1130-01082006000100003
Abstrakt:	Objective: To contribute our experience for five years in the implemetation of outpatient laparoscopic cholecystectomy (LC). Patients: Between January 1999 and March 2004 we performed 504 outpatient LCs. We applied both exclusion and inclusion criteria, an anesthetic and surgical protocol, and discharge-specific criteria. Postoperative management in "fast track" regime. Postoperative period controlled by protocol, including phone calls after cholecystectomy. Results: The ambulatory percentage in the global series was 88.8%, and mean hospital stay was 6.1 hours. Fifty-one patients required overnight stays (10.1%), most of them for "social" causes. Five patients required admission (between 24 and 48 hours) for different causes (conversion to laparotomy, intraoperative neumothorax, and postoperative medical complications). Six patients (1.1%) were readmitted, and we observed 11.6% postoperative complications in the global series, with abdominal parietal pain being most frequent. Phone localization by 22.00 p.m. in the same day of surgery was 100% complete for outpatient cases. Postoperative surveillance within the first month after surgery was completed in 93.9%, and within th first year in 86.7% of patients. Conclusions: Outpatient LC is safe and feasible, and probably represents a new "gold standard" in the treatment of symptomatic cholelithiasis.
Databáze:	MEDLINE
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