Routine day-case laparoscopic cholecystectomy

Abstract

Abstract Background A prospective study was carried out to assess the feasibility of performing true day-case laparoscopic surgery in a district general hospital. Methods All patients admitted consecutively under the care of one surgeon for laparoscopic cholecystectomy were included in the study. Selection criteria for a day-case procedure included an American Society of Anesthesiologists grade of I or II and the availability of a responsible carer at home. Patients were discharged 4–6 h after surgery with a standard analgesia pack and a contact number for advice. All patients were contacted by telephone on the day after discharge. A postal questionnaire was sent to the first 100 patients to assess satisfaction with the day-case process. Results Of 357 patients admitted for laparoscopic cholecystectomy over a 24-month period, 154 (43·1 per cent) were operated on as day cases on a morning theatre list. Twenty-two patients required an overnight stay (14·3 per cent), three because of conversion to an open procedure. One patient was readmitted for neck pain. Eighty-two (92·1 per cent) of 89 patients were either satisfied or very satisfied with the day-case procedure. Conclusion This study has demonstrated a low rate of overnight stay (14·3 per cent) and readmission (1·9 per cent), and a high degree of patient satisfaction for day-case laparoscopic cholecystectomy.