Day-Case Laparoscopic Cholecystectomy: Is it a Safe and Feasible Procedure?

Aim: Laparoscopic cholecystectomy (LC) is the most common minimally invasive surgery in Turkey. However, Day case LC is not a common practice in Turkey. The purpose of this work was to evaluate the feasibility, benefits(advantage of cost effectivenes) and safety outcome of elective laparoscopic cholecystectomy as a daycase procedure in our hospital.
Method: 40 Patients who had received laparoscopic cholecystectomy for various bening gallbladder pathologies. Laparoscopic cholecystectomies were performed by an experienced surgeon or a surgeon-in-training with an experienced surgeon as an assistant in the American position through four trocars. Operations were performed under general anaesthesia. They were admitted and operated on in the morning hours and discharged after a double check by the surgeon and an anaesthetist 4 to 6 hours later. For the purpose of this study, we defined the following criteria as prerequisites for same-day discharge after 6-8 hours of monitoring in the DS ward: ability to tolerate oral feeds; ability to pass urine spontaneously; and ability to ambulate independently.
Result: Two hundred laparoscopic cholecystectomies were performed in day case surgery from January 2009 to December 2009. Of fourty patients selected for day case LC, 90% were discharged successfully after 6-8 hrs observation. No significant perioperative complications were noted. Unplanned admission and readmission rate was 10%, respectively. All four patients (10%) were discharged the next day. Two of the patients (5%) who underwent DS LC successfully were readmitted on a later date.They were succesfully treated.
Conclusion: These results suggest that laparoscopic cholecystectomy can be routinely performed as a day-case procedure.

Keywords
Postoperative nausea and vomiting, laparoscopic cholecystectomy, day-case