Prasad A, Foley R J
Department of Surgery, Bedford Hospital, England.
Eur J Surg. 1996 Jan;162(1):43-6.
To evaluate the safety and cost effectiveness of laparoscopic cholecystectomy as a day case procedure.
District hospital, England.
103 patients undergoing laparoscopic cholecystectomy.
Laparoscopic cholecystectomy by a standard four cannula technique. Propofol anaesthesia, prophylactic antiemetics and pre-emptive analgesia were given in all cases.
Morbidity and cost.
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.
This is a safe and cost-effective procedure and should be considered in selected patients.
评估腹腔镜胆囊切除术作为日间手术的安全性和成本效益。
英国地区医院。
103例行腹腔镜胆囊切除术的患者。
采用标准四套管技术进行腹腔镜胆囊切除术。所有病例均给予丙泊酚麻醉、预防性止吐药和超前镇痛。
发病率和成本。
103例患者接受了腹腔镜胆囊切除术，其中51例为日间手术。如果患者年龄在60岁以下、希望当天回家、无黄疸病史或任何麻醉禁忌证，且家中有成年人照顾，则选择其进行日间治疗。被选为日间手术的患者中有3例需要过夜住院，1例因剧痛，2例需要留置引流管过夜。中位住院时间为12小时（范围10 - 28小时），手术费用约为419英镑。
这是一种安全且具有成本效益的手术方法，并应在选定的患者中予以考虑。
