Surgical Endoscopy

, Volume 10, Issue 1, pp 52–56

149 ambulatory laparoscopic cholecystectomies

  • M. A. Fiorillo
  • P. G. Davidson
  • M. Fiorillo
  • J. A. D’Anna
  • N. Sithian
  • R. J. Silich
Article

Abstract

Background

The purpose of this study was to compare ambulatory laparoscopic cholecystectomy (LC) with overnight LC and to determine its safety and the factors which will predict its success.

Methods

Ambulatory LC was defined as LC followed by less than a 12-h stay in the ambulatory surgery unit; overnight LC was defined as LC followed by a hospital admission of less than 24 h. A retrospective chart review was completed.

Results

One hundred forty-nine ambulatory LC, were performed in an 18-month period. Ninety-one were successful (61%); 58 patients required overnight admission for pain management, control of nausea, or their reluctance to be discharged. There were five complications and no mortalities. The duration of the surgical procedure was the only significant objective factor we could find in predicting success of ambulatory LC.

Conclusions

We conclude that ambulatory LC is safe and effective in treating patients requiring cholecystectomy. The duration of the procedure and the patient’s own motivation are key factors in predicting success of early discharge.

Key words

Laparoscopic cholecystectomy Ambulatorysurgery Complications 

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References

  1. 1.
    Arregui ME, Davis CJ, Arkush A, Nagan RF (1991) In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospital charges. Surg Laparosc Endosc 1: 240–245PubMedCrossRefGoogle Scholar
  2. 2.
    Biswas TK, Leary C (1992) Postoperative hospital admission from a day surgery unit: a seven year retrospective survey. Anaesth Intensive Care 20: 147–150PubMedGoogle Scholar
  3. 3.
    Doherty VC, O’Donovan TR, Hill GJ (1988) Current status of ambulatory surgery in the United States. In: Hill G (ed) Outpatient surgery, 3rd ed. WB Saunders, Philadelphia, pp 1–6Google Scholar
  4. 4.
    American Society of Anesthesiologists (1963) New classification of physical status. Anesthesiology 24: 111Google Scholar
  5. 5.
    Gold BS, Kitz DS, Lecky JH, Neuhaus JM (1989) Unanticipated admission to the hospital following ambulatory surgery. JAMA 262: 3008–3010PubMedCrossRefGoogle Scholar
  6. 6.
    Lantz PE, Smith JD (1994) Fatal carbon dioxide embolism complicating attempted laparoscopic cholecystectomy—case report and review of the literature. J Forensic Sci 39: 1468–1480PubMedGoogle Scholar
  7. 7.
    Meeks GR, Waller GA, Meydrech EF, Flautt FH (1992) Unscheduled hospital admission following ambulatory gynecologic surgery. Obstet Gynecol 80: 446–450PubMedGoogle Scholar
  8. 8.
    Mühe E (1986) Die erste Cholecystektomie durch das Laparoskop. Arch Klin Chir 369: 804Google Scholar
  9. 9.
    Osborne GA, Rudkin GE (1993) Outcome after day-care surgery in a major teaching hospital. Anaesth Intensive Care 21: 822–827PubMedGoogle Scholar
  10. 10.
    Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, Roby SR, Front ME, Carey LC (1991) Safety and efficacy of laparoscopic cholecystectomy. Ann Surg 213: 3–12PubMedCrossRefGoogle Scholar
  11. 11.
    Reddick EJ, Olsen DO, Daniell JF, Saye WB (1989) Laparoscopic laser cholecystectomy. Laser Med Surg News Adv 7: 38–40Google Scholar
  12. 12.
    Reddick EJ, Olsen DO (1990) Outpatient laparoscopic laser cholecystectomy. Am J Surg 160: 485–489PubMedCrossRefGoogle Scholar
  13. 13.
    Scott TR, Zucker KA, Bafley RW (1992) Laparoscopic cholecystectomy: a review of 12,397 patients. Surg Laparosc Endosc 2: 191–198PubMedGoogle Scholar
  14. 14.
    Southern Surgeons Club (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324: 1073–1078CrossRefGoogle Scholar
  15. 15.
    Stephenson BM, Sage M, Callander C, Vellacott KD (1993) Feasibility of “day case” laparoscopic cholecystectomy. Ann R Coll Surg Engl 75: 249–251PubMedGoogle Scholar
  16. 16.
    Turfah F, Nazzal M Azhar A, Lakra Y (1994) Laparoscopic cholecystectomy: analysis of the complications at a community hospital. Surg Laparosc Endosc 4: 264–267PubMedGoogle Scholar
  17. 17.
    Zilberstein B, Cecconello I, Ramos AC, Sallet JA, Pinheiro EA (1994) Hemobilia as a complication of laparoscopic cholecystectomy. Surg Laparosc Endosc 4: 301–303PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1996

Authors and Affiliations

  • M. A. Fiorillo
    • 1
  • P. G. Davidson
    • 1
    • 2
  • M. Fiorillo
    • 3
  • J. A. D’Anna
    • 1
    • 2
  • N. Sithian
    • 1
    • 2
  • R. J. Silich
    • 1
  1. 1.Department of SurgeryStaten Island University HospitalStaten IslandUSA
  2. 2.Department of SurgeryState University of New York Health Science Center at BrooklynNYUSA
  3. 3.State University of New York at BinghamtonVestal Parkway EastBinghamtonUSA
  4. 4.Staten Island Surgical AssociatesStaten IslandUSA

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