Cost-effectiveness of ambulatory laparoscopic cholecystectomy

The merits of laparoscopic cholecystectomy include faster recovery, less po stoperative pain, earlier return to work, and decreased cost. However, ther e are few economic data comparing laparoscopic cholecystectomy in an ambula tory versus overnight stay setting. In a 12-month period, 74 consecutive ch olecystectomies were performed laparoscopically by one surgeon. The ambulat ory group consisted of 36 patients who were discharged from the hospital th e same day after a mean recovery time of 5 hours (range, 2.25-10.33). Of th e remaining 38 patients, 19 were admitted after surgery on 23-hour observat ion status, and 19 were inpatients. The average hospital cost was significa ntly less in the ambulatory group than in the observation group, with an 11 % mean reduction in cost per patient (P = 0.0061). No patient in either gro up was readmitted to the hospital within 30 days of surgery. Laparoscopic c holecystectomy can be performed safely in an outpatient setting. The cost s avings of ambulatory care versus observation are clearly shown in this stud y.