Laparoscopic Cholecystectomy in Outpatient Surgery Clinic


Authors: M. Škrovina 1;  S. Czudek 1;  J. Matloch 2;  D. Říha 2;  L. Adamčík 1;  M. Duda 1
Authors‘ workplace: Chirurgické oddělení, Onkocentrum J. G. Mendela a Nemocnice Nový Jičín, primár: MUDr. S. Czudek, CSc. 1;  Centrum cévní a miniinvazivní chirurgie, Nemocnice Podlesí, Třinec, primár: MUDr. D. Říha 2
Published in: Rozhl. Chir., 2007, roč. 86, č. 8, s. 449-453.
Category: Monothematic special - Original

Overview

Aim:
Based on literature data and their own experience, the authors present a view that, in a selected group of patients, ambulatory laparoscopic cholecystectomy may be performed with no increased risks and with good outcomes.

Material and Methods:
The retrospective study presents a group of 93 patients, 72 females and 21 males, who underwent ambulatory laparoscopic procedures for symptomatic cholecystolithiasis in the Podlesí Hospital Centre of Miniinvasive Surgery, from January 2003 to the end of June 2006. 61.3% of the patients were in their forties and fifties, 69.9 % of the patients were classified as ASA II, according to the surgical risk. Half of the patients had an ideal body weight, according to their body mass index (BMI) assessment.

Results:
No peroperative or postoperative complications were recorded in the above, closely selected group of patients. 84 patients (90.3%) were discharged to homecare on the day of the procedure. Nine patients (9.7%) required hospitalization for the first postoperative night and they were discharged the following morning., i.e. within 24 hours after the procedure. None of the subjects, discharged after the ambulatory procedure, required rehospitalization.

Conclusion:
Similarly to studies presented in the literature worldwide, the authors concluded that laparoscopic cholecystectomy perforemed in the outpatient regime appears an appropriate surgical method in closely selected patient groups. In our setting, out of the total of 618 operated patients, who underwent laparoscopic cholecystectomy during the studied period, 15.4% could be managed using the above method.

Key words:
cholecystectomy – laparoscopy – outpatient surgery


Sources

1. Schirmer, B. D., Edge, S. B., Dix, J., Hyser, M. J., Hanks, J. B., Jones, R. S. Laparoscopic cholecystectomy. Treatment of choice for symptomatic cholelithiasis. Ann. Surg., 1991, 213: 665–677.

2. Moss, G. „Mini-trauma“ cholecystectomy. J. Abdom. Surg., 1983, 25: 66–74.

3. Zegarra II, R. F., Saba, A. K., Peschiera, J. L. Outpatient laparoscopic cholecystectomy: safe and cost effective? Surg. Laparosc. Endosc., 1997, 7(6): 487–490.

4. Livingston, E. H., Rege, R. V. A nationwide study of conversion from laparoscopic to open cholecystectomy. Am. J. Surg., 2004, 188: 205–211.

5. Ludwig, K., Lorenz, D., Koeckerling, F. Surgical strategies in the laparoscopic therapy of cholecystolithiasis and common duct stones. ANZ J. Surg., 2002, 72: 547–552.

6. Fletcher, D. R., Hobbs, M. S., Tan, P., Valinsky, L. J., Hockey, R. L., Pikora, T. J., Knuiman, M. W., Sheiner, H. J., Edis, A. Complications of cholecystectomy: risks of the laparoscopic approach and protective affects of operative cholangiography: a population-based study. Ann. Surg., 1999, 229: 449–457.

7. Duda, M., Gryga, A., Czudek, S., Skalický, P. Chirurgie a miniinvazivní metody v České republice. SK Chir., 2006, 3(1), 20–26.

8. Dostalík, J., Martínek, L., Guňková, P., Guňka, I. Miniinvazivní chirurgie v České republice. Rozhl. Chir., 2006, 85(7), 361–364.

9. Johanes, R., Holéczy, P., Hamžík, J. Minulosť, súčasnosť a budúcnosť laparoskopie na Slovensku. SK Chir., 2006, 3(3), 9–15.

10. Reddick, E. J., Olsen, D. O. Outpatient laparoscopic laser cholecystectomy. Am. J. Surg., 1990, 160: 485–487.

11. Voyles, C. R., Berch, B. R. Selection criteria for laparoscopic cholecystectomy in a ambulatory care setting. Surg. Endosc., 1997, 11: 1145–1146.

12. Czudek, S., Adamčík, L., Škrovina, M. Jednodenní chirurgie. Prakt. Lék., 2006, 86(1), 13–19.

13. Arregui, M. E., Davis, C. J., Arkush, A., Nagan, R. F. In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospitalisation charges. Surg. Laparosc. Endosc., 1991, 1: 240–245.

14. Farha, G. J., Green, B. P., Beamer, R. L. Laparoscopic cholecystectomy in a freestanding outpatient surgery center. J. Laparoendosc. Surg., 1994, 4(5): 291–294.

15. Llorente, J. Laparoscopic cholecystectomy in the ambulatory surgery setting. J. Laparoendosc. Surg., 1992, 2: 23–26.

16. Reddick, E. J. Laparoscopic cholecystectomy in freestanding outpatient centers. J. Laparoendosc. Surg., 1992, 2: 65–67.

17. Calland, J. F., Tanaka, K., Foley, E., Bovbjerg, V. E., Markey, D. W., Blome, S., Minasi, J. S., Hanks, J. B., Moore, M. M., Yong, J. S., Jones, R. S., Schirmer, B. D., Adams, R. B. Outpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Ann. Surg., 2001, 233(5): 704–715.

18. Keulemans, Y., Eshuis, J., de Haes, H., de Wit, L. T., Gouma, J. D. Laparoscopic cholecystectomy: day-care versus clinical observation. Ann. Surg., 1998, 228(6): 734–740.

19. Campanelli, G., Cavagnoli, R., Cioffi, U., De Simone, M., Fabbiani, M., Pietri, P. Can laparoscopic cholecystectomy be a day surgery procedure? Hepato-Gastroenterology, 1998, 45: 1422–1429.

20. Voitk, A. J. Is outpatient cholecystectomy safe for the higher-risk elective patient? Surg. Endosc., 1997, 11: 1147–1149.

21. Narain, P. K., DeMaria, E. J. Initial results of a prospective trial of outpatient laparoscopic cholecystectomy. Surg. Endosc., 1997, 11: 1091–1094.

22. Voitk, A. J. Routine outpatient laparoscopic cholecystectomy. Can. J. Surg., 1995, 38(3): 262–265.

23. Fiorello, M. A., Davidson, P. G., Fiorello, M., D’Anna, J. A. Jr, Sithian, N., Silich, R. J. 149 ambulatory laparoscopic cholecystectomies. Surg. Endosc., 1996, 10: 52–56.

24. Fassiadis, N., Pepas, L., Grandy-Smith, S., Paix, A., El-Hasani, S. Outcome and patient acceptance of outpatient laparoscopic cholecystectomy. JSLS, 2004, 8(3): 251–253.

25. Robinson, T. N., Biffl, W. L., Moore, E. E., Heimbach, J. K., Calkins, C. M., Burch, J. M. Predicting failure outpatient laparoscopic cholecystectomy. Am. J. Surg., 2002, 184: 515–519.

26. Skattum, J., Edwin, B., Trondsen, E., Mjaland, O., Raeder, J., Buanes, T. Outpatient laparoscopic surgery: feasibility and consequences for educations and health care costs. Surg. Endosc., 2004, 18: 796–801.

27. Farha, G. J., Mullins, J. R., Beamer, R. L. Laparoscopic cholecystectomy in a private community setting. J. Laparoendosc. Surg., 1992, 2: 75–80.

28. Ryska, M., Bělina, F. První zkušenosti s laparoskopickou cholecystektomií v podmínkách poliklinické praxe. Bulletin HPB chirurgie, 1993, 1, 2–3: 20–22.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account