Ambulatory laparoscopic cholecystectomy: Is it safe and cost effective?

Background : Laparoscopic cholecystectomy (LC) is the most commonly performed minimal invasive surgery. However, practice of its use as an ambulatory surgery in our hospital settings is uncommon.
Objective : To evaluate safety and cost effectiveness of LC as an ambulatory day care surgery.
Study Design : Quasiexperimental.
Setting : Department of surgery, Aga Khan University Hospital, Karachi, Pakistan.
Materials and Methods : Patients with uncomplicated symptomatic gallstones were selected for Ambulatory LC. They were admitted electively on the same day and operated on in the morning hours and discharged after a check by the surgeon 6-8 hrs later.
Results : Of fifty (n = 50) patients selected for ambulatory LC, 92% were discharged successfully after 6-8 hrs observation. No significant perioperative complications were noted. Unplanned admission and readmission rate was 8 and 2%, respectively. Cost saving for the daycare surgery was Rs. 6,200, Rs. 13,300, and Rs.22,800 per patient as compared to in patient general, semiprivate, and private ward package, respectively.
Conclusion : Practice ambulatory LC is safe and cost-effective in selected patients with uncomplicated symptomatic gallstones.