Laparoscopic cholecystectomy performed as ambulatory major surgery in a regional hospital. Initial results of a series of 110 cases

Introduction: The aim of our study was to analyze the reliability of laparoscopic cholecystectomy (LC) in an Ambulatory Surgery unit, in order to encourage its use and achieve better management of health resources. Material and method: Retrospective study of 110 patients operated on for LC between September 2004 and November 2008. The selection criteria were: absence of prior supramesocolic abdominal surgery, no previous admission for acute cholecystitis, absence of stones in the bile ducts and normal liver function tests, no intake of oral anticoagulants or antiplatelet agents and ASA I-II. All patients were operated using a previously established Major Ambulatory Surgery (MAS) protocol. Results: The patients included 81 women and 29 men, with a mean age of 51.03 years (range 24-77), of which 57 had a medical and / or surgical history. The overall morbidity was 6.36% with a mortality of 0%. The conversion rate was 0.9%. A total of 87 patients (79.1%) were discharged at 6 h after surgery, thus fulfilling the criteria of the MAS system. The mean overall hospital stay was 1.49 days (median 0). The reoperation rate WAS 1.81% and the rate of readmission after discharge was 0.9%. Conclusions: The performance of outpatient laparoscopic cholecystectomy is feasible and safe. It should be integrated into the activities of Major Ambulatory Surgery, ensuring careful selection of patients and interest by surgeon who performs it. (C) 2009 AEC. Published by Elsevier Espana, S.L. All rights reserved.