Day case laparoscopic cholecystectomy: a safe and cost effective procedure.

OBJECTIVE

To evaluate the safety and cost effectiveness of laparoscopic cholecystectomy as a day case procedure.

SETTING

District hospital, England.

SUBJECTS

103 patients undergoing laparoscopic cholecystectomy.

INTERVENTIONS

Laparoscopic cholecystectomy by a standard four cannula technique. Propofol anaesthesia, prophylactic antiemetics and pre-emptive analgesia were given in all cases.

MAIN OUTCOME MEASURES

Morbidity and cost.

RESULTS

103 patients have undergone laparoscopic cholecystectomy, 51 of them as day cases. Patients were selected for day treatment if they were under 60 years old, they wanted to go home the same day, they had no history of jaundice or any anaesthetic contraindication, and if there was an adult at home to look after them. Three of those selected as day cases required overnight admission, one because of severe pain and two who required a drain overnight. The median hospital stay was 12 hours (range 10-28 hours) and the cost of the operation was about pounds 419.

CONCLUSION

This is a safe and cost-effective procedure and should be considered in selected patients.