FEASIBILITY OF DAY-CASE LAPAROSCOPIC CHOLECYSTECTOMY IN UNSELECTED PATIENTS

The feasibility of day case laparoscopic cholecystectomy was assessed in unselected patients using a standard anaesthetic protocol. Postoper ative pain and nausea were assessed at 6 and 24 h postoperatively (vis ual analogue scale, range 0-10). Thirty-two patients were studied (23 female, 9 male, mean age 49.6 years). The mean duration of surgery was 68 min. At 6 h after surgery, 10 patients (31%) had no pain at rest. For the group as a whole, the median pain score was 3 at rest (range 0 -6), 4 on movement (0-9), and 5 on coughing (0-9) and eight patients ( 25%) were nauseated. At 24 h, 15 (46.9%) had no pain at rest. For the group as a whole, the median pain score was 1 at rest (0-7), 3 (0-6) o n movement and 3 on coughing (0-9). The same eight patients were nause ated. Ten patients (31.3%) were judged fit for discharge at 6 h, and 2 8 (87.5%) by 24 h. There was no statistical difference in mean age or duration of surgery in those judged fit for early discharge compared t o the study group as a whole. Nausea was an important factor in those unfit for discharge at 24 h. Selection criteria might improve these fi gures. From the results of our study, 24 h admission is a more realist ic goal and will be suitable for most patients requiring laparoscopic cholecystectomy.