DAY-CASE LAPAROSCOPIC CHOLECYSTECTOMY - A SAFE AND COST-EFFECTIVE PROCEDURE

Objective: To evaluate the safety and cost effectiveness of laparoscop ic cholecystectomy as a day case procedure. Setting: District hospital , England. Subjects: 103 patients undergoing laparoscopic cholecystect omy. Interventions: Laparoscopic cholecystectomy by a standard four ca nnula technique. Propofol anaesthesia, prophylactic antiemetics and pr e-emptive analgesia were given in all cases. Main outcome measures: Mo rbidity and cost. Results: 103 patients have undergone laparoscopic ch olecystectomy, 51 of them as day cases. Patients were selected for day treatment if they were under 60 years old, they wanted to go home the same day, they had no history of jaundice or any anaesthetic contrain dication, and if there was an adult at home to look after them. Three of those selected as day cases required overnight admission, one becau se of severe pain and two who required a drain overnight. The median h ospital stay was 12 hours (range 10-28 hours) and the cost of the oper ation was about pound 419. Conclusion: This is a safe and cost-effecti ve procedure and should be considered in selected patients.