Narain P K, DeMaria E J
Department of Surgery, Box No. 980475, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, VA 23298-0475, USA.
Surg Endosc. 1997 Nov;11(11):1091-4. doi: 10.1007/s004649900537.
Whether or not laparoscopic cholecystectomy may be performed safely as an outpatient procedure is controversial. In 1993, a protocol for outpatient laparoscopic cholecystectomy was instituted to determine the benefits and safety of discharging patients within several hours of surgery.
The initial 60 outpatient laparoscopic cholecystectomies performed by one surgeon in a hospital-based outpatient teaching facility between February 1993 to June 1996 were prospectively studied.
Fifty-eight (97%) patients were discharged successfully after an average stay in the recovery room of 3 h. There were no deaths. Two patients required overnight observation and three patients required readmission. Two patients (3%) had cystic duct leak. The average hospital stay for all patients undergoing laparoscopic cholecystectomy at the institution (inpatient and outpatient) decreased from 3.2 to 1.5 days and the average hospital cost decreased from $7,800 to $4,600 during this period.
Laparoscopic cholecystectomy in an outpatient setting is safe and cost-effective in healthy patients.
腹腔镜胆囊切除术作为门诊手术是否能安全进行存在争议。1993年,制定了一项门诊腹腔镜胆囊切除术方案,以确定在手术数小时内让患者出院的益处和安全性。
对1993年2月至1996年6月期间一名外科医生在一家医院门诊教学机构进行的最初60例门诊腹腔镜胆囊切除术进行前瞻性研究。
58例(97%)患者在恢复室平均停留3小时后成功出院。无死亡病例。2例患者需要过夜观察,3例患者需要再次入院。2例患者(3%)出现胆囊管渗漏。在此期间,该机构所有接受腹腔镜胆囊切除术的患者(住院和门诊)的平均住院时间从3.2天降至1.5天,平均住院费用从7800美元降至4600美元。
在健康患者中,门诊腹腔镜胆囊切除术是安全且具有成本效益的。