Unanticipated Hospital Admission after Outpatient Laparoscopic Cholecystectomy

Bojsen, Elise V; Madsen, Mogens Rørbæk

doi:10.15761/gos.1000153

Cited by 2 publications

(3 citation statements)

References 12 publications

(28 reference statements)

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“…Therefore, the operative time was significantly longer (145 vs. 115 min, P <0.001). Although complications from LC can impact the duration of hospital stay, operative time has been identified as a predictor or influential factor on postoperative hospital stay after LC 12 , 36 , 37 . Moreover, patients with a history of acute cholecystitis, cholangitis, or pancreatitis and patients with an abdominal drain or pain score greater than 3, severe postoperative pain, or postoperative nausea and vomiting had a longer hospital stay 37 , 38 .…”

Section: Discussionmentioning

confidence: 99%

“…Although complications from LC can impact the duration of hospital stay, operative time has been identified as a predictor or influential factor on postoperative hospital stay after LC 12 , 36 , 37 . Moreover, patients with a history of acute cholecystitis, cholangitis, or pancreatitis and patients with an abdominal drain or pain score greater than 3, severe postoperative pain, or postoperative nausea and vomiting had a longer hospital stay 37 , 38 . Despite differences in LC complications between the groups, there was no significant difference in complication rate, conversion to open surgery, 30-day reoperation, and 30-day readmission rates in this study.…”

Section: Discussionmentioning

confidence: 99%

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Propensity score-matched comparison of safety outcomes between high-risk and low-risk patients towards early hospital discharge after laparoscopic cholecystectomy

Cheewatanakornkul,

Yolsuriyanwong,

Wangkulangkul

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Laparoscopic cholecystectomy (LC), a common treatment for symptomatic gallstones, has demonstrated safety in low-risk patients. However, existing data is scarce regarding the safety of LC in high-risk patients and the feasibility of early hospital discharge. Materials and Methods: This retrospective study included 2296 patients diagnosed with symptomatic gallstones who underwent LC at a tertiary care center from January 2009 through December 2019. We employed propensity score matching to mitigate bias between groups. Statistical significance was set at P<0.05. Results: The median age of the patients was 56 years (range 46–67), with a mean Body Mass Index (BMI) of 25.2±4.3 kg/m2. Patients were classified as: American Society of Anesthesiologists (ASA) I (19.7%), II (68.3%), III (12.0%), and IV (0%). ASA I–II included low surgical risk patients (88%) and ASA III-IV comprised high-risk patients (12%). The LC-related 30-day reoperative rate was 0.2% and the readmission rate was 0.87%. Nine patients (0.4%) sustained major bile duct injuries, resulting in a conversion rate of 2.4%. The postoperative mortality rate was 0.04%, and the mean hospitalization time was 3.5 days. Patients in the high-risk group with a history of acute cholecystitis exhibited greater estimated blood loss, longer operative times, and were significantly more likely to be in the longer-stay group. Conclusion: Our findings suggest that LC can be conducted safely on high-risk patients, and early hospital discharge is achievable. However, specific factors, such as a history of acute cholecystitis, may result in prolonged hospitalization owing to increased blood loss and longer operative times.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Propensity score-matched comparison of safety outcomes between high-risk and low-risk patients towards early hospital discharge after laparoscopic cholecystectomy

Cheewatanakornkul,

Yolsuriyanwong,

Wangkulangkul

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Postoperative nausea and vomiting (PONV) is one of the most frequent causes of unpredicted delay in discharge after ambulatory surgery. Despite various strategies to decrease its occurrence, it is still recounted in 50-70% of patients [1][2][3][4]. For ambulatory surgery, patients must meet established criteria for patients scoring C9 on the postanesthesia discharge scoring system (PADS) [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of Preoperative Carbohydrate Drink and Postoperative Chewing Gum on Postoperative Nausea and Vomiting in Patients Undergoing Day Care Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Balabolu,

Abuji,

Soni

et al. 2023

World j. surg.

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Background Postoperative nausea and vomiting (PONV) causes an unexpected prolonged hospital stay after ambulatory surgery. Novel measures such as preoperative loading of oral carbohydrates and postoperative chewing gum have recently gained momentum for postoperative recovery. This study evaluated the effects of preoperative carbohydrate loading and postoperative chewing gum (CG) on PONV after daycare laparoscopic cholecystectomy (LC). Methods A total of 100 patients were randomized to group A (preoperative carbohydrate loading with 200 ml of water with 25 g of carbohydrate and postoperative chewing gum (CG) when the patient responded to his/her name) and group B (standard care). The incidence of PONV and pain was assessed by using visual analogue scale. Quality of recovery (QoR-15) was assessed by using QoR15 questionnaire at 6 h, 24 h and 48 h after surgery. Results The incidence of PONV and pain was lower in group A; however, it was not significant (p [ 0.05). The severity of PONV, pain and the need for rescue antiemetic was significantly lower in group A (p \ 0.05). The episodes of PONV and required dose of antiemetic were less in group A. Group A also had a significantly higher QoR-15 score at all time points (p \ 0.001). Preoperative dyspepsia was also noticed as a significant confounding predictor for postoperative vomiting. Conclusion Preoperative carbohydrate drinks and early postoperative CG reduces the severity of PONV and requirement of antiemetics in patients undergoing LC. Hence, these simple measures can be used as a standard of care to optimize perioperative care in patients undergoing daycare surgery.

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Unanticipated Hospital Admission after Outpatient Laparoscopic Cholecystectomy

Cited by 2 publications

References 12 publications

Propensity score-matched comparison of safety outcomes between high-risk and low-risk patients towards early hospital discharge after laparoscopic cholecystectomy

Propensity score-matched comparison of safety outcomes between high-risk and low-risk patients towards early hospital discharge after laparoscopic cholecystectomy

Effect of Preoperative Carbohydrate Drink and Postoperative Chewing Gum on Postoperative Nausea and Vomiting in Patients Undergoing Day Care Laparoscopic Cholecystectomy: A Randomized Controlled Trial

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