OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY - SAFE AND COST-EFFECTIVE

Among the many advantages of laparoscopic cholecystectomy (LC), which has become the standard of care for symptomatic gallbladder disease, i s the decrease in hospital stay. Although some studies of outpatient L C are starting to appear, few compare return visits to the hospital up to 30 days after surgery as well as cost of hospitalization between a group of outpatients and overnight admission patients. From January t hrough December 1994, 415 LCs were attempted at Good Samaritan Hospita l. Total hospitalization char Ps were obtained fora comparable subset of the outpatient and 24-h observation patients. There were 229 LCs pe rformed without difficulty on an outpatient basis and 40 performed wit h a 24-h hold. Of the 229 outpatient LCs, only 1.3% had minor problems related to LC. Of the 90 LCs performed with 24-h hold, only 2.2% had problems related to the LC. The average charge for LC with overnight a dmission $4,890.37; the average charge for outpatient surgery was $3,6 69.54 (p < 0.0001). There was no increase in patient morbidity or mort ality associated with outpatient LC. The cost savings for outpatient s urgery compared with surgery with 24-h admission was 25%.