Is Outpatient Laparoscopic Cholecystectomy Safe and Cost Effective? A Model to Study Transition of Care

Fleisher, Lee A.; Yee, Kelvin; Lillemoe, Keith D.; Talamini, Mark A.; Yeo, Charles J.; Heath, Roberta; Bass, Eric B.; Snyder, Douglas S.; Parker, Stephen

doi:10.1097/00132586-200006000-00001

Cited by 19 publications

(30 citation statements)

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“…The acceptability of same-day discharge has been reported in populations outside the UK, with satisfaction rates varying from 71-95%. 4,[17][18][19][20][21] In this study, 94% of patients were highly satisfied with the service we provided, both in the discharged and admitted groups. Sixteen significant intra-operative difficulties in 15 patients were encountered (Table 6).…”

Section: A B Introduction Of a Day-case Laparoscopic Cholecystectomy mentioning

confidence: 59%

Introduction of a Day-Case Laparoscopic Cholecystectomy Service in the UK: A Critical Analysis of Factors Influencing Same-Day Discharge and Contact with Primary Care Providers

Briggs

Irving

Mann

et al. 2009

annals

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INTRODUCTION The objective of this study was to determine the safety and acceptability of the implementation of a day-case laparoscopic cholecystectomy (LC) service in a large UK teaching hospital, and analyse factors influencing contact with primary care providers. Wide-spread introduction of day-case LC in the UK is a major target of healthcare providers. However, few centres have reported their experience. In the US, out-patient surgery for LC has been reported, though many groups have utilised 24-h observation units to facilitate discharge. Concerns remain amongst surgeons regarding the feasibility and acceptability of the introduction of day-case LC in the UK. PATIENTS AND METHODS Comprehensive care and operative data were prospectively collected on the first 106 consecutive day-case procedures in our hospital. Postoperative recovery was monitored by telephone questionnaire on days 2, 5 and 14, including complications, satisfaction and general practitioner consultation. RESULTS A total of 106 patients were admitted for day-case LC, of whom 84% were discharged on the day of surgery. Patient satisfaction rate was 94% in both the successful day-case and the admitted patients. Mean operation time was 62 min, with an average total stay on the day-care unit of 426 min. Training-grade surgeons performed 31% of operations. Both the re-admission rate after surgery and rate of conversion to open surgery were 2%. Advice from primary healthcare providers was sought by 33% of patients within the first 14 postoperative days. CONCLUSIONS Introduction of day-case LC in the UK is feasible and acceptable to patients. The potential burden to primary care providers needs further study.

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Section: A B Introduction Of a Day-case Laparoscopic Cholecystectomy mentioning

confidence: 59%

Introduction of a Day-Case Laparoscopic Cholecystectomy Service in the UK: A Critical Analysis of Factors Influencing Same-Day Discharge and Contact with Primary Care Providers

Briggs

Irving

Mann

et al. 2009

annals

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“…Existing experience relates to practice in private health care centers where facilities are in accordance with published western guidelines [68,69], A centre without previous experience, and without infrastructure to support major day care surgery, needs to evolve well reasoned guidelines with a rigid and honest appraisal of outcomes to identify deficiencies and potential pitfalls. The viability of our inclusion criteria and the feasibility of Day Care surgery in our practice was analysed using successful discharge, post operative symptoms readmission and complication rates, ease and accuracy of follow up and the potential benefit to our surgical service from Day Care surgery based on Day Care Laparoscopic Cholecystectomy as a model was examined.…”

Section: Discussionmentioning

confidence: 99%

Day Care Laproscopic Cholecystectomy – A Prospective Study

Singh¹

2017

IOSR JDMS

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“…In Baltimore, Fleisher et al reported that the cost of laparoscopic cholecystectomy was decreased in ambulatory vs inpatients (from $4,000 to $2,000). 3 However, that study did not include health professional compensation and there was a surprising difference in OR cost between inpatients and ambulatory patients ($1,800 vs $760). What is the cost of a few days in the nearest hotel?!…”

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confidence: 97%

“…ont constaté qu'à Baltimore le coût de la cholécystec-tomie laparoscopique était plus bas pour un patient ambulatoire vs un patient hospitalisé (passant de 4 000 $ à 2 000 $). 3 Cependant, cette étude ne comprend pas le salaire des professionnels de la santé et on note une différence surprenante du coût de la SO entre les patients hospitalisés et ambulatoires (1 800 $ vs 760 $) . Quel est le coût de quelques jours à l'hôtel le plus proche ?…”

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The hidden cost of anesthesia

Bevan

2002

Can J Anesth/J Can Anesth

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Is Outpatient Laparoscopic Cholecystectomy Safe and Cost Effective? A Model to Study Transition of Care

Cited by 19 publications

References 0 publications

Introduction of a Day-Case Laparoscopic Cholecystectomy Service in the UK: A Critical Analysis of Factors Influencing Same-Day Discharge and Contact with Primary Care Providers

Introduction of a Day-Case Laparoscopic Cholecystectomy Service in the UK: A Critical Analysis of Factors Influencing Same-Day Discharge and Contact with Primary Care Providers

Day Care Laproscopic Cholecystectomy – A Prospective Study

The hidden cost of anesthesia

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