CAN LAPAROSCOPIC CHOLECYSTECTOMY BE A DAY SURGERY PROCEDURE

BACKGROUND/AIMS: Gallbladder surgery by videolaparoscopy (VL) is now a ble to obtain the same goals as traditional surgery, and is associated with comparable or better results both in terms of positive surgical outcome and patient satisfaction. With public health spending under gr owing social and administrative pressure, and continuous efforts fucus ing on enhancing the efficiency of both surgical instruments and opera ting procedures, it is a most attractive, albeit initially challenging , prospect to regard video-laparoscopic surgery as day-case surgery. H erein, the authors assess the outpatient treatment option, due to rece nt technical developments and relevant major organizational and profes sional implications, and consider the feasibility of day-case surgery projects which should soon be implemented. METHODOLOGY: From January 1 994 to December 1996, 1,334 patients underwent videolaparoscopic chole cystectomy. Of these, 898 were women and 436 men. In 1,034 of the lapa roscopies gas was used and 300 were performed without gas. Out of the total 1,334 patients who were submitted to the videolaparoscopic chole cystectomy procedure with or without the use of gas, 72 (5.4%) were tr eated on an outpatient basis. RESULTS: In our series, 93.5% of patient s reported normal post-operative functions within 24 hours; 90.2% of p atients were able to take oral fluid on the same day of the operation and had normal bowel peristalsis within the first post-operative day. CONCLUSIONS: The authors assess the outpatient option treatment, due t o recent technical developments and relevant major organizational and professional implications, and consider the feasibility of a day-case surgery project which should soon be implemented.