Madan Atul K, Speck Karen E, Ternovits Craig A, Tichansky David S
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
Am J Surg. 2006 Sep;192(3):399-402. doi: 10.1016/j.amjsurg.2005.12.013.
The benefits of laparoscopic gastric bypass (LGB) include decreased pain, quicker recovery, and shorter hospital stay. Our hypothesis was that a clinical pathway for 48-hour discharge after LGB can be implemented safely.
Charts of patients undergoing LGB were retrospectively reviewed to assess our prospectively placed clinical pathway. Patients were discharged within 48 hours if they met the criteria of the pathway.
There were 104 patients who underwent LGB with no intraoperative conversions. Complications included 5 leaks, 5 reoperations, and no mortality. In our series, 76% (n=79) of patients were discharged within 48 hours. Gender and body mass index (BMI) did not differ between those who were discharged in 48 hours and those who were not (P=not significant). No patient who was discharged in 48 hours required return before their scheduled appointment.
A majority of patients after LGB can be discharged safely in 48 hours. A formal clinical pathway helps decrease hospital stay without adverse patient outcome.
腹腔镜胃旁路手术（LGB）的益处包括疼痛减轻、恢复更快以及住院时间缩短。我们的假设是，LGB术后48小时出院的临床路径能够安全实施。
对接受LGB手术的患者病历进行回顾性分析，以评估我们预先设定的临床路径。符合路径标准的患者在48小时内出院。
104例患者接受了LGB手术，无术中中转开腹情况。并发症包括5例渗漏、5例再次手术，无死亡病例。在我们的系列研究中，76%（n = 79）的患者在48小时内出院。48小时内出院患者与未在48小时内出院患者的性别和体重指数（BMI）无差异（P = 无显著性差异）。48小时内出院的患者在预定复诊前均无需返回。
大多数LGB术后患者可在48小时内安全出院。正式的临床路径有助于缩短住院时间，且不会对患者产生不良后果。
