Laparoscopic cholecystectomy as an outpatient procedure.

BACKGROUND

Laparoscopic cholecystectomy is still done mainly on an inpatient basis at hospitals or on an outpatient basis at ambulatory care departments inside hospitals.

METHODS

We reviewed 213 cases in which outpatient laparoscopic cholecystectomy was done at an ambulatory surgical center not associated with a hospital physically or administratively. Patients were selected solely on the basis of medical history and physical examination results. Patients received general anesthesia as is typical for outpatient procedures. Narcotic use was minimized to prevent postoperative nausea. The procedure did not include intraoperative cholangiography.

RESULTS

Laparoscopic cholecystectomy took 1 to 2 hours in three quarters of patients. Rate of conversion to open cholecystectomy was 2.8% (6 of 213 patients). The mean recovery period was 6.6 hours, and 97% of patients were discharged on the same day (ie, were treated as outpatients). We identified no cases of retained common duct stone. Wound complications included mainly seroma, wound seepage, and wound infection; 18% of these complications were seen at trocar sites. No major complications were seen.

CONCLUSIONS

Elective outpatient laparoscopic cholecystectomy can be done safely with low morbidity, high patient acceptance, and same-day discharge in > 95% of cases.