LAPAROSCOPIC CHOLECYSTECTOMY AS A DAY SURGERY PROCEDURE

Outcome is presented for 40 consecutive laparoscopic cholecystectomies performed in a public teaching hospital day surgery unit, The unantic ipated hospital admission rate on the day of surgery was 17.5% (seven patients) and the majority of these (12.5%; five patients) were due to surgery-related considerations. Two other admissions were due to naus ea and vomiting. One patient was admitted to hospital on the second po stoperative day with nausea and vomiting. Procedure duration for the d ay cases averaged 98 minutes (SD25; range 60-167). Recovery room times before discharge averaged 272 minutes (SD 58; range 125-365), Each da y surgery patient averaged 3.3 postoperative home visits from communit y nurses. Most patients (94%) mobilized at home by the second postoper ative day and 85% resumed normal activities of daily living by two wee ks. At follow-up, 25 patients (76%) stated they were happy to spend th e first night at home, but seven (21%) would have preferred to remain in hospital for the first postoperative night. Laparoscopic cholecyste ctomy can be performed successfully as a day-case procedure, but long operating and recovery room times and potentially high admission rates suggest that these factors should be considered in cost equations for daycase management of this procedure.