Short-stay daycare laparoscopic cholecystectomy at a dedicated daycare centre: Feasible or futile

Abstract

BACKGROUND:In the last decade, laparoscopic cholecystectomy (LC) has become a regular daycare surgery at many centres across the world. However, only a few centres in India have a dedicated daycare surgery centre, and very few of them have reported their experience. Concerns remain regarding the feasibility, safety and acceptability of the introduction of daycare laparoscopic cholecystectomy (DCLC) in India. There is a need to assess the safety and acceptability of the implementation of short-stay DCLC service at a centre completely dedicated to daycare surgery.PATIENTS AND METHODS:Comprehensive care and operative data were retrospectively collected from a daycare centre of our hospital. Postoperative recovery was monitored by telephone questionnaire on days 0, 1 and 5 postoperatively, including adverse outcomes.RESULTS:A total of 211 patients were admitted for DCLC during the period from November 2011 till November 2014, of whom 211 were discharged on the day of surgery. Two hundred and two patients could be discharged within 6 h of surgery. Mean operation time was 72 min. No patient required admission. No patient needed conversion to open surgery. Only 1 patient was re-admitted due to bilioma formation and was managed with minimal intervention.CONCLUSION:The introduction of short-stay DCLC in India is feasible and acceptable to patients. High body mass index (BMI) in otherwise healthy patients and selective additional procedures are not contraindications for DCLC.

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

“…Figure 1 shows the modified PRISMA flowchart for identification and inclusion of relevant papers. Twenty-three studies were excluded from the meta-analysis; 10 papers were deemed low quality [ 53 – 61 ] and 13 papers did not provide readmission rates specific to LC [ 62 – 74 ].…”

“…Bile duct injury accounted for 30 cases. Bile leak was not reported as a complication in Rosero et al [8] However, it was reported in a number of other studies as a cause for readmission and accounted for 32 cases [9,10,20,22,34,39,41,42,[50][51][52]75]. Pain (16%), surgical site occurrence (14%) cardiorespiratory complications (9%), and unrelated medical (6%) account for the remainder.…”

Laparoscopic cholecystectomy as a day surgery operation: two centers experience.

“…[26,27] Postoperative nausea and vomiting (PNOV) are the leading postoperative complications in cases of DSLC, several randomised controlled studies reported its occurrence yet there is no fixed nor specific pre-anesthetic drug regimens to treat such symptoms [28] Postoperative nausea and vomiting with DSLC surgery is responsible for about 0.1 -0.2% of unanticipated admissions [29] . In our study, few patients suffered from PONV that is why we report a 97% success rate of day surgery cases discharge Postoperative pain prolonged hospital stays in the ambulatory setting [30]. Various drug regimens have been reported to prevent and reduce postoperative pain, which is a significant factor for early patient ambulation and increased satisfaction for the outpatient procedure [31].…”

Is it Time to Embark on Laparoscopic Daycare Surgery in Resource-Limited Settings? Perspectives from a Series of Laparoscopic Heller’s Myotomy and Fundoplication for Achalasia Cardia

“…Daycare laparoscopic surgeries have gained significant acceptance across various medical fields, with positive results documented for most frequently conducted procedures such as laparoscopic cholecystectomy, hernia repair, hysterectomy, and others. [9][10][11] Moreover, uncomplicated daycare laparoscopic upper GI surgeries (i.e., Heller's myotomy and fundoplication) have also been performed with low complication rates. 12,13 These cases, as presented, have shown comparable outcomes, except for longer hospital stays.…”