预测门诊腹腔镜胆囊切除术的失败情况。
Predicting failure of outpatient laparoscopic cholecystectomy.
作者信息
Robinson Thomas N, Biffl Walter L, Moore Ernest E, Heimbach Julie K, Calkins Casey M, Burch Jon M
机构信息
Department of Surgery, Denver Health Medical Center/University of Colorado Health Sciences Center, USA.
出版信息
Am J Surg. 2002 Dec;184(6):515-8; discussion 518-9. doi: 10.1016/s0002-9610(02)01080-2.
BACKGROUND
Outpatient laparoscopic cholecystectomy (LC) is safe and feasible, but factors related to the failure of outpatient surgery are poorly defined. We hypothesized that patients in whom same day discharge (SDD) is unlikely may be identified preoperatively.
METHODS
Three hundred eighty-seven consecutive patients scheduled for elective LC were prospectively enrolled in an outpatient clinical pathway.
RESULTS
In all, 269 (70%) patients successfully underwent outpatient LC. Factors related to failure of SDD were age, American Society of Anesthesiology (ASA) class, surgery start time, and duration of surgery. Body mass index, liver function tests, and ultrasound findings did not predict failure of SDD. Three factors were able to predict more than 50% failure of SDD: age more than 50 years, ASA class 3 or more, and surgery start time later than 1:00 PM.
CONCLUSIONS
Outpatient LC is feasible in a large county hospital. These data may be used in scheduling cases and counseling patients.
背景
门诊腹腔镜胆囊切除术（LC）是安全可行的，但与门诊手术失败相关的因素尚不明确。我们推测，术前可能识别出不太可能当日出院（SDD）的患者。
方法
连续387例计划行择期LC的患者前瞻性纳入门诊临床路径。
结果
总共269例（70%）患者成功接受了门诊LC。与SDD失败相关的因素包括年龄、美国麻醉医师协会（ASA）分级、手术开始时间和手术时长。体重指数、肝功能检查和超声检查结果不能预测SDD失败。三个因素能够预测超过50%的SDD失败：年龄超过50岁、ASA分级为3级或更高、手术开始时间晚于下午1:00。
结论
门诊LC在大型县级医院是可行的。这些数据可用于安排病例和为患者提供咨询。
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