OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY

Introduction The results of laparoscopic cholecystectomy performed as an outpatient procedure were evaluated in a prospective study. Methods Initially, only well motivated and healthy patients were offered outp atient laparoscopic cholecystectomy. After 50 procedures, all patients referred to the hospital, except those with American Society of Anest hesiologists (ASA) grade IV and those living alone, were included. Som e 200 procedures were studied. Results Twelve patients (6 per cent) we re admitted, and 188 (94 per cent) were discharged 4-8 h after operati on. Fifteen patients (8 per cent) who had early discharge were readmit ted, nine with complications: in six no complications were documented. The frequency of minor complications was 2 per cent and of major comp lications 5 per cent. Some 173 patients who had successful outpatient laparoscopic cholecystectomy completed a questionnaire: 164 (95 per ce nt) characterized their experience as excellent, five (3 per cent) as good: two (1 per cent) as intermediate and two (1 per cent) as unaccep table. Discussion This high achievement of day-case treatment, even in patients with ASA grade III, is explained by a new anaesthetic regime n together with good surgical technique and close follow-up.