A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy

Ahmad, NZ; Byrnes, Gerard J.; Naqvi, SA

doi:10.1007/s00464-008-9867-2

Cited by 87 publications

(64 citation statements)

References 43 publications

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“…Nevertheless, the medical cost was significantly higher [26]. In Taiwan, the average length of hospital stay for open and laparoscopic cholecystectomy is 13.1 and 4.9 days, Analysis of gallstone disease after gastric cancer surgery respectively, which is longer than that reported in other countries, not to mention those performing laparoscopic cholecystectomy as an outpatient procedure [19,27]. The longer hospital stay in Taiwan may be related to the different treatment protocol or cultural difference [19].…”

Section: Discussionmentioning

confidence: 99%

Analysis of gallstone disease after gastric cancer surgery

et al. 2017

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Background The incidence rate of newly developed gallstone disease after gastrectomy for gastric cancer is thought to be higher than that in the general population. However, the presentation and management of these gallstones remain under debate, and the role of prophylactic cholecystectomy remains questionable. Methods Data on adult patients who were diagnosed with gastric cancer and received gastrectomy between 2000 and 2011 were extracted from the Taiwan National Health Insurance Research Database. A patient was excluded if he or she had gallstone disease or received cholecystectomy before the index date. The incidence of newly developed gallstone disease and its subsequent management were recorded. Data were analyzed to evaluate the factors associated with gallstone development and treatment options. Results A total of 17,325 gastric cancer patients who underwent gastrectomy were eligible for analysis. During the follow-up period (mean 4.1 years; median, 2.9 years), 1280 (7.4%) patients developed gallstone disease and 560 (3.2%) patients subsequently underwent cholecystectomy. The in-hospital mortality for cholecystectomy was 1.8% (10/560). Development of gallstone disease was associated with older age, total gastrectomy, duodenal exclusion, diabetes, cirrhosis, and more comorbidities. Factors associated with the use of cholecystectomy to treat gallstone disease included younger age, fewer comorbidities, medical center admission, and presentation as cholecystitis. Conclusions Although few patients required further gallbladder removal after gastrectomy for gastric malignancy, the increased mortality rate for subsequent cholecystectomy was worth noting. The decision to undergo prophylactic cholecystectomy might be individualized based upon patient characteristics and the surgeon's discretion.

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Section: Discussionmentioning

confidence: 99%

Analysis of gallstone disease after gastric cancer surgery

et al. 2017

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“…Laparoscopic cholecystectomy performed safely in an ambulatory setting has become widely popular and accepted [19,20]. Our LOS was primarily 1-2 days, with more than half of the patients discharged in the ambulatory setting.…”

Section: Discussionmentioning

confidence: 99%

Single-port-access (SPATM) cholecystectomy: a multi-institutional report of the first 297 cases

et al. 2010

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Background An important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry. Methods Data were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data. Results To date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1-2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred. SPATM is a Trademark

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“…2 In our district general hospital, laparoscopic cholecystectomy is performed both electively for symptomatic gallstone disease, and also as an emergency procedure during an acute admission. Previous studies have reported 30-day re-admission rates of 2-5% following elective laparoscopic cholecystectomy, 3,4 and 6% following emergency laparoscopic cholecystectomy. 5 However, in our experience, patients can present with symptoms several weeks after laparoscopic cholecystectomy, and there is little data regarding re-admission rates after 30 days' postoperatively.…”

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confidence: 94%

Low ninety-day re-admission rates after emergency and elective laparoscopic cholecystectomy in a district general hospital

Down

Nicolic

Abdulkarim

et al. 2010

annals

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Ann R Coll Surg Engl 2010; 92: 307-310 307The incidence of cholelithiasis in the UK is 11-22%; approximately 10% of cases are symptomatic.1 Each year, over 25 000 patients are admitted to English hospitals with acute gallbladder disease, and 15% undergo emergency cholecystectomy. 2 In our district general hospital, laparoscopic cholecystectomy is performed both electively for symptomatic gallstone disease, and also as an emergency procedure during an acute admission. Previous studies have reported 30-day re-admission rates of 2-5% following elective laparoscopic cholecystectomy, 3,4 and 6% following emergency laparoscopic cholecystectomy. 5 However, in our experience, patients can present with symptoms several weeks after laparoscopic cholecystectomy, and there is little data regarding re-admission rates after 30 days' postoperatively. In addition, there are very few studies comparing postoperative outcomes following emergency laparoscopic cholecystectomy in district general hospitals and larger teaching units.Our aim was to determine whether there is a difference in 90-day re-admission rates following either elective or emergency laparoscopic cholecystectomy, and to compare our outcomes at a UK district general hospital with larger teaching centres. Patients and MethodsThe study was conducted at a district general hospital within eastern England with a catchment population of 180,000. Twenty-five patients were re-admitted within 90 days of their operation, of whom only 14 had complications directly related to their surgery (overall re-admission rate 4.3%). There was no statistical difference in re-admission rate or cause of re-admission between elective and emergency procedures. However, the mean time to re-admission following elective procedures was significantly longer (36 days; P = 0.0003). CONCLUSIONS Re-admission rates at our district general hospital are comparable to those reported by larger teaching centres. Current 30-day re-admission data may significantly underestimate morbidity rates and socio-economic cost following elective laparoscopic cholecystectomy. GASTROINTESTINAL SURGERY

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A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy

Abstract: Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction.

Cited by 87 publications

References 43 publications

Analysis of gallstone disease after gastric cancer surgery

Analysis of gallstone disease after gastric cancer surgery

Single-port-access (SPATM) cholecystectomy: a multi-institutional report of the first 297 cases

Low ninety-day re-admission rates after emergency and elective laparoscopic cholecystectomy in a district general hospital

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