Leeder, P.C.; Mathews, T.; Dehn, T.C.B.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA115
Academic Journal
Aim: A prospective study was carried out to assess the feasibility of performing true day case laparoscopic surgery in a district general hospital setting. Methods: All patients admitted consecutively under the care of one surgeon for laparoscopic cholecystectomy were included in the study. Laparoscopic cholecystectomy has been performed as a day case at the study hospital since July 2000. Selection criteria for day case procedure included an American Society of Anaesthesiologists score of I to III and the availability of a responsible carer at home. Patients were discharged four to six hours after surgery with a standard analgesia pack and a contact number for advice. All patients were contacted by telephone on the day following discharge. In addition, a postal questionnaire was sent to the first 80 patients to assess satisfaction with the day case process. Results: Out of a total of 357 patients admitted for laparoscopic cholecystectomy over a 22 month period, 154 were deemed suitable for day case surgery (43%). Female to male ratio was 4:1, with a median age of 51 (range 19 to 79). Twenty-two patients required overnight stay (14 %), two because of open conversion. One patient was readmitted for neck pain. Eighty-eight per cent of patients were either satisfied or very satisfied with the day case procedure. Conclusion: With appropriate patient selection and staff education, routine day case laparoscopic cholecystectomy is a practical option. The above study demonstrates a Iow admission rate and a high degree of patient satisfaction.


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