Laparoscopic Cholecystectomy Used In Outpatient

OBJECTIVE: The possibility and feasibility of outpatient laparoscopic cholecystectomy (OPLC) is controversial in CHINA. This prospective consecutive follow-up study has been performed to determine the safety and cost saving of OPLC.METHODS: 55 patients were divided into two groups. OPLC group consisted of 26 patients who underwent OPLC with a recovery time of 6-8 hours. LC group comprised 29 patients who underwent LC and postoperative observation of more than 24 hours. Patients who were scheduled for LC by an attending group surgeons. All patients received a standardized epidural anesthesia. OPLC group patients were discharged from the outpatient-observing ward if appropriate. At discharge, all patients were observed by their family members so as to have necessitated readmission. Data were gathered regarding patient preoperative diagnosis, preoperative laboratory values, length of stay after surgery, and complications. These data were analyzed using "Independent Sample T test" (SPSS 10.0). RESULTS: No patient was transferred to open cholecystectomy and no major complications such as common bile duct injury or huge bleedingwas observed in these OPLC patients who met the discharge criteria for home. Only one patient experienced postoperative severe nausea and vomiting, and required readmission. The median length of stay after operation was 7. 19 hours. The average total charge for OPLC group patients was 4108.73 RMB versus 5068.17 RMB of LC group (t=31. 664, p<0. 001). 25/26 patients of OPLC expressing satisfaction with this experience versus 28/29 patients of LC (Chi square test: X2=0. 4131, P>0. 05).CONCLUSION: Operative effectiveness was equal in both patient groups, and both group patients and their family member appeared to be satisfied with their treatments. Because no differences were found with respect to the other outcomes, we conclude that outpatient laparoscopic cholecystectomy can be done safely and cost effectively with discharge home after 6-8 hours postoperative hospital stay in selective patients.