Day-case laparoscopic cholecystectomy: a prospective evaluation of a 6-year experience

Background/Purpose. Day-case laparoscopic cholecystectomy (LC) offers convenience to patients and cost saving to the healthcare institutes. This article reviews our prospectively recorded experience with day-case LC to determine its applicability and safety, as well as patient satisfaction. Methods. Of 744 consecutive patients who underwent LC over a 6-year period, 140 (19%) were scheduled for day-case surgery. Selection criteria included American Society of Anesthesiologists (ASA) score of 1 or 2, absence of morbid obesity, low risk for common bile duct stones, domicile within 50?km of the hospital, age greater than 18 and less than 75, and the ability to admit the patient on the day of surgery for operation during the morning. Patient satisfaction with day-case surgery was assessed by questionnaire at 4–6 weeks after operation. Results. Some 117 of the 140 patients (84%) were discharged home on the same day of the operation. Two patients were re-admitted with abdominal pain, 1 of whom underwent a negative re-laparoscopy. There were no major complications. The reasons for overnight hospital stay were anesthetic in 12 (52%), surgical in 7 (30%), and social or logistic in 4 (18%) patients. There were no conversions. The proportion of patients scheduled for day-case remained static (median, 18.5%; range, 16%–22%). Some 99 of 105 patients (94%) who completed the questionnaire were satisfied with day-case surgery. Conclusions. In carefully selected patients, day-case LC is achievable and safe, and provides good patient satisfaction.