Zegarra R F, Saba A K, Peschiera J L
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
Surg Laparosc Endosc. 1997 Dec;7(6):487-90.
Among the many advantages of laparoscopic cholecystectomy (LC), which has become the standard of care for symptomatic gallbladder disease, is the decrease in hospital stay. Although some studies of outpatient LC are starting to appear, few compare return visits to the hospital up to 30 days after surgery as well as cost of hospitalization between a group of outpatients and overnight admission patients. From January through December 1994, 415 LCs were attempted at Good Samaritan Hospital. Total hospitalization charges were obtained for a comparable subset of the outpatient and 24-h observation patients. There were 229 LCs performed without difficulty on an outpatient basis and 90 performed with a 24-h hold. Of the 229 outpatient LCs, only 1.3% had minor problems related to LC. Of the 90 LCs performed with 24-h hold, only 2.2% had problems related to the LC. The average charge for LC with overnight admission $4,890.37; the average charge for outpatient surgery was $3,669.54 (p < 0.0001). There was no increase in patient morbidity or mortality associated with outpatient LC. The cost savings for outpatient surgery compared with surgery with 24-h admission was 25%.
腹腔镜胆囊切除术（LC）已成为有症状胆囊疾病的标准治疗方法，其诸多优点之一是住院时间缩短。尽管一些关于门诊LC的研究开始出现，但很少有研究比较术后30天内的复诊情况以及一组门诊患者和过夜入院患者之间的住院费用。1994年1月至12月，善萨玛利亚医院共尝试进行了415例LC手术。获取了门诊患者和24小时观察患者中可比子集的总住院费用。有229例LC手术在门诊顺利完成，90例进行了24小时观察。在229例门诊LC手术中，只有1.3%出现了与LC相关的小问题。在90例进行24小时观察的LC手术中，只有2.2%出现了与LC相关的问题。过夜入院LC手术的平均费用为4,890.37美元；门诊手术的平均费用为3,669.54美元（p < 0.0001）。门诊LC手术并未增加患者的发病率或死亡率。与24小时入院手术相比，门诊手术节省的费用为25%。
