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日间腹腔镜胆囊切除术:患者选择因素综述及当日出院潜在障碍的识别

Day case laparoscopic cholecystectomy: a review of patient selection factors and identification of potential barriers to same-day discharge.

作者信息

Rickward Jamie, Hameed Iman, Ho Simon, Wijeratne Shiran

机构信息

University of Notre Dame Sydney, Sydney, New South Wales, Australia.

Werribee Mercy Hospital, Melbourne, Victoria, Australia.

出版信息

ANZ J Surg. 2024 Dec;94(12):2119-2127. doi: 10.1111/ans.19241. Epub 2024 Oct 9.

Abstract

BACKGROUND

Day-case laparoscopic cholecystectomy (DCLC) is a useful tool for minimizing hospital admissions and prolonged presurgical wait times in suitable patient cohorts. There have been many international studies to support this finding and an increasing interest has grown in implementation in Australia. This review aims to provide clarity how to best implement this tool in gallbladder disease patient demographic.

OBSERVATIONS

This literature review evaluates studies on day-case cholecystectomy procedures, focusing on patient factors, procedural aspects, surgical morbidity, and systemic implications. It explores inclusion and exclusion criteria for day-case suitability, factors influencing same-day discharge, reasons for hospital admission, pain management, patient quality of life, patient satisfaction, and cost implications.

CONCLUSIONS

DCLC, when selected judiciously, is a safe alternative to overnight stay procedures for cholecystectomy with comparable surgical outcomes and patient satisfaction, affirming its viability. Strict patient selection criteria can aid in optimizing the successful implementation procedure, reducing unexpected admissions and readmissions and we have demonstrated useful criteria for guidance in establishing day-case laparoscopic cholecystectomy protocol at a hospital.

摘要

背景

日间腹腔镜胆囊切除术(DCLC)是一种有用的手段,可减少合适患者群体的住院次数和术前等待时间。已有许多国际研究支持这一发现,并且在澳大利亚,人们对实施该手术的兴趣日益浓厚。本综述旨在阐明如何在胆囊疾病患者人群中最佳地应用这一手段。

观察

本文献综述评估了日间胆囊切除术的相关研究,重点关注患者因素、手术操作方面、手术并发症及全身影响。探讨了日间手术适宜性的纳入和排除标准、影响当日出院的因素、住院原因管理、疼痛管理、患者生活质量、患者满意度及成本影响。

结论

谨慎选择时,DCLC是胆囊切除术后过夜住院手术的一种安全替代方案,手术效果和患者满意度相当,证实了其可行性。严格的患者选择标准有助于优化手术的成功实施,减少意外住院和再入院情况,我们已展示了在医院建立日间腹腔镜胆囊切除术方案时可供指导的有用标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a373/11713220/b344f62a60c0/ANS-94-2119-g003.jpg

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