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[腹腔镜胆囊切除术作为门诊手术]

[Laparoscopic cholecystectomy as an outpatient procedure].

作者信息

Jakobsen Henrik Loft, Gögenur Ismail, Jacobsen Bo, Vilmann Peter, Rosenberg Jacob

机构信息

Amtssygehuset i Gentofte, Kirurgisk Gastroenterologisk Afdeling D.

出版信息

Ugeskr Laeger. 2005 Jun 13;167(24):2641-3.

Abstract

INTRODUCTION

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.

MATERIALS AND METHODS

A prospective evaluation was done of the first 231 patients undergoing laparoscopic cholecystectomy in an outpatient clinic.

RESULTS

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.

DISCUSSION

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.

摘要

引言

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。

材料与方法

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。

结果

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。

讨论

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。

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