Jakobsen Henrik Loft, Gögenur Ismail, Jacobsen Bo, Vilmann Peter, Rosenberg Jacob
Amtssygehuset i Gentofte, Kirurgisk Gastroenterologisk Afdeling D.
Ugeskr Laeger. 2005 Jun 13;167(24):2641-3.
The aim of this study was to describe our experience with laparoscopic cholecystectomy as an outpatient procedure in terms of complications, same-day discharge, and a registration of patient' postoperative pain, convalescence and contact with general practitioners.
A prospective evaluation was done of the first 231 patients undergoing laparoscopic cholecystectomy in an outpatient clinic.
Ninety per cent of the patients were discharged directly from the outpatient clinic, and a total of 93% of the patients were discharged within 24 hours of the operation. The readmission rate was 1%. Leakage from the cystic duct occurred in one case (0.4%), and no other injuries to the bile ducts were observed. The conversion rate was 1%. Within a week 54% of the patients had no pain and 55% of the patients had resumed normal activity. Postoperatively, 25% of the patients had contact with a general practitioner due to wound and other complaints that required no intervention.
Laparoscopic cholecystectomy is very suitable as an outpatient procedure due to its high same-day discharge rate and high patient satisfaction combined with low readmission and complication rates. Our study did expose, however, a high number of postoperative contacts with general practitioners due to non-surgical problems, which emphasizes the need for better patient information and cooperation with general practitioners to optimize the outpatient procedure further.
本研究的目的是描述我们在门诊进行腹腔镜胆囊切除术的经验,包括并发症、当日出院情况,以及患者术后疼痛、康复情况和与全科医生的联系记录。
对门诊首批231例行腹腔镜胆囊切除术的患者进行前瞻性评估。
90%的患者直接从门诊出院,93%的患者在术后24小时内出院。再入院率为1%。胆囊管漏出1例(0.4%),未观察到其他胆管损伤。中转开腹率为1%。一周内,54%的患者无疼痛,55%的患者恢复正常活动。术后,25%的患者因伤口及其他无需干预的不适症状与全科医生取得联系。
腹腔镜胆囊切除术因其当日出院率高、患者满意度高、再入院率和并发症发生率低,非常适合作为门诊手术。然而,我们的研究确实发现,由于非手术问题,患者术后与全科医生联系的次数较多,这强调需要更好地向患者提供信息,并与全科医生合作,以进一步优化门诊手术。