OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY FEASIBILITY

One-hundred nineteen elective cholecystectomies were performed at Kern Medical Center over a 20-month period from October 1992 to May 1994 a nd were retrospectively reviewed. Eight males and 111 females ranged i n age from 16 to 70. Laparoscopic cholecystectomy was attempted in 116 patients and converted to open in 8 (7%). Of the elective procedures, 108 (91%) were planned as outpatient procedures. Of the 108 planned o utpatient procedures, 73 (68%) were successfully completed as outpatie nts. Of the 35 patients who required unplanned admission, 21 were disc harged in less than 24 h. In total, 101 (87%) of the 116 elective chol ecystectomies begun laparoscopically were discharged in less than 24 h . Subsequent to this data analysis, our institution is developing a 23 .9 h ''day hospital'' for postanesthesia observation. With extended po stoperative monitoring and observation, patients with short-term probl ems such as nausea, vomiting, pain, and even patients with medical con ditions requiring close observation and control should be able to avoi d admission. This retrospective study indicates that with development of a 23.9 h postanesthesia care unit, the majority of elective cholecy stectomies can be attempted and completed laparoscopically on an outpa tient basis.