Outpatient Laparoscopic Cholecystectomy: Experience of a Nonovernight Surgicenter

Abstract

From April 1994 to September 1998, a total of 66 laparoscopic cholecystectomies were performed at the same-day freestanding Surgicenter of the Yankton Medical Clinic. All patients (ages 15 to 62 years; 91% women) were discharged the same day, and no patient required hospitalization despite two conversions to open cholecystectomy. Cholangiofluoroscopies were completed in 70% of the patients. Pathologic evaluation showed chronic cholecystitis in all patients except one, who also had acute disease. No patient was lost to follow-up, and 98% responded that they "would do it again." These results confirm the safety of laparoscopic cholecystectomy in selected patients in a low- and controlled-cost environment of a freestanding surgical facility. Interestingly, Medicare does not allow facility reimbursement for cholecystectomy in any nonovernight outpatient surgery center in South Dakota.

Outpatient laparoscopic cholecystectomy: clinical pathway implementation is efficient and cost effective and increases hospital bed capacity

“…These data are similar to those of earlier reports from other studies [1,2,4,7,10,14,16]. The success rate for ambulatory surgery is partly related to appropriate patient selection, but it also strongly depends on extensive education of both the health care professionals and the patients who undergo this care.…”

Intent at day case laparoscopic cholecystectomy in Owerri, Nigeria: Initial experiences

“…[267] This is more convenient for the patient and more cost-effective for the hospital in the face of competing demands for available bed spaces. This is not the case in Nigeria where most day surgery cases are managed in general surgical wards.…”

“…This has been shown to be quite effective in the developed countries where there are well established day surgery facilities. [23] Developing countries have also shown the feasibility and safety of conducting day case laparoscopic cholecystectomy. [45] Laparoscopic cholecystectomy has been the default operation for symptomatic gall stones in our health facility since 2007.…”

Safety and effectiveness of outpatient laparoscopic cholecystectomy in a teaching hospital: a prospective study of 110 consecutive patients

“…Various drug regimens and other methods have been reported and proposed to prevent and reduce postoperative pain, which is a significant factor for early patient mobilization and increased satisfaction for the outpatient procedure [ 27 - 29 ]. Pre-incisional infiltration of portal sites as well as intraperitoneal infusion of local anesthetics, pethidine and normal saline have been reported as effective and reasonable options for pain control [ 4 , 6 , 10 - 12 , 30 , 31 ]. In our study, postoperative pain was minimal due to effective drug protocols and pre-incisional infiltration of ropivacaine in trocar sites.…”