The Advantage of Ambulatory Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIBei ,  LINing , YEHui , LIFu-yu , YOUZhen , CHENLi-ping

Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

LINing, Email: hobadehoy@gmail.com

Keywords：

Cholecystolithiasis; Laparoscopic cholecystectomy; Day-case surgery; Health economics

DOI：

10.7507/1007-9424.20140290

Video：

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Objective To investigate the feasibility, safety, cost, and patient satisfaction of ambulatory laparo-scopic cholecystectomy(ALC). Methods The clinical data of patients who divided into ALC group(678 cases) and in-patient laparoscopic cholecystectomy(IPLC) group(1 534 cases) in our hospital from April 2011 to December 2012 were retrospectively analyzed. The operative time, conversion rate, complication rate, hospitalization time, cost of hospi-talization, rehospitalization rate, and patient satisfaction were analyzed and evaluated. Results There were no significant differences of the operative time, postoperative complication rate, and rehospitalization rate between the 2 groups(P > 0.05). The conversion rate(0.44%), and hospitalization time[(1.2±0.5)d] of the ALC group were significantly lower or shorter than those of IPLC group[3.19%, (4.8±1.3) d], P < 0.05. The direct, indirect health care costs, and the total costs of the ALC group were (6 555.6±738.7), (230.0±48.0), and (8 856.0±636.0) yuan, respec-tively; and lower than those of the IPLC group[(7 863.71, 014.6), (973.0±136.5), and(8 856.0±636.0)yuan], P < 0.05. Conclusion ALC is safe and feasible, and could shorten the hospitalization time, lower the medical cost, speed up the bed turnover, and increase the efficiency in the use of health resource.

Citation： LIBei, LINing, YEHui, LIFu-yu, YOUZhen, CHENLi-ping. The Advantage of Ambulatory Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1207-1211. doi: 10.7507/1007-9424.20140290 Copy

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3.	Chauhan A, Mehrotra M, Bhatia PK, et al. Day care laparoscopic cholecystectomy:a feasibility study in a public health service hospital in a developing country[J]. World J Surg, 2006, 30(9):1690-1695.
4.	Labaille T, Mazoit JX, Paqueron X, et al. The clinical efficacy and pharmacokinetics of intraperitonealropivacaine for laparoscopiccholecystectomy[J]. Anesth Analg, 2002, 94(1):100-105.
5.	Proske JM, Dagher I, Revitea C, et al. Day-case laparoscopic cholecystectomy:results of 211 consecutive patients[J]. Gastroenterol Clin Biol, 2007, 31(4):421-424.
6.	Bona S, Monzani R, Fumagalli Romario U, et al. Outpatient laparoscopic cholecystectomy:a prospective study of 250 patients[J]. Gastroenterol Clin Biol, 2007, 31(11):1010-1015.
7.	Chang SK, Tan WB. Feasibility and safety of day surgery laparoscopic cholecystectomy in a university hospital using a standard clinicalpathway[J]. Singapore Med J, 2008, 49(5):397-399.
8.	Calland JF, Tanaka K, Foley E, et al. Outpatient laparoscopic cholecystectomy:patient outcomes after implementation of a clinical pathway[J]. Ann Surg, 2001, 233(5):704-715.
9.	Chok KS, Yuen WK, Lau H, et al. Outpatient laparoscopic cholecystectomy in Hong Kong Chinese--an outcome analysis[J]. Asian J Surg, 2004, 27(4):313-316.
10.	Bueno Lledó J, Planells Roig M, Arnau Bertomeu C, et al. Outpatient laparoscopic cholecystectomy:a new gold standard for cholecystectomy[J]. Rev Esp Enferm Dig, 2006, 98(1):14-24.
11.	Sinha S, Munikrishnan V, Montgomery J, et al. The impact of patient-controlled analgesia on laparoscopic cholecystectomy[J]. Ann R Coll Surg Engl, 2007, 89(4):374-378.
12.	Psaila J, Agrawal S, Fountain U, et al. Day-surgery laparoscopic cholecystectomy:factors influencing same-day discharge[J]. World J Surg, 2008, 32(1):76-81.
13.	Parvaiz MA, Hafeez R. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy[J]. Br J Surg, 2006, 93(5):639-640.
14.	Lam D, Miranda R, Hom SJ. Laparoscopic cholecystectomy as an outpatient procedure[J]. Am Coll Surg, 1997, 185(2):152-155.
15.	Lillemoe KD. Laparoscopic cholecystectomy as a "true" outpatient procedure:initial experience in 130 consecutive patients[J]. Gastrointest Surg, 1999, 3(1):44-49.
16.	Mjaland O, Raeder J, Aasboe V, et al. Outpatient laparoscopic cholecystectomy[J]. Br J Surg, 1997, 84(7):958-961.
17.	Skattum J, Edwin B, Trondsen E, et al. Outpatient laparoscopic surgery:feasibility and consequences for education and health care costs[J]. Surg Endosc, 2004, 18(5):796-801.
18.	Voitk AJ, Tsao SG, Ignatius S. The tail of the learning curve for laparoscopic cholecystectomy[J]. Am J Surg, 2001, 182(3):250-253.
19.	Jain PK, Hayden JD, Sedman PC, et al. A prospective study of ambulatory laparoscopic cholecystectomy:training economic, and patient benefits[J]. Surg Endosc, 2005, 19(8):1082-1085.
20.	吴志明, 娄建平, 代明盛, 等.一日腹腔镜胆囊切除术26例分析[J].腹腔镜外科杂志, 2008, 13(5):434-435.
21.	沈火剑, 李可为, 季福, 等.日间腹腔镜胆囊切除术的临床应用分析[J].肝胆胰外科杂志, 2011, 23(1):43-45.
22.	徐靖, 赵永捷, 江涛, 等.过夜腹腔镜胆囊切除术分析68例[J/CD].中华腔镜外科杂志:电子版, 2011, 4(6):456-460.
23.	嵇武, 丁凯, 王丹, 等.门诊腹腔镜胆囊切除术与住院腹腔镜胆囊切除术的对照研究[J].医学研究所学报, 2010, 23(3):258-262.
24.	李可为, 丁俊, 陈涛, 等.日间腹腔镜胆囊切除25例分析[J].肝胆胰外科杂志, 2010, 22(1):48-49.
25.	李关平, 罗艳霞, 雷静, 等.腹腔镜胆囊切除术开展日间手术的可行性探讨[J].现代预防医学, 2010, 37(23):4576-4577.

1. Reynolds W Jr. The first laparoscopic cholecystectomy[J]. JSLS, 2001, 5(1):89-94.
2. Reddick FJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy[J]. Am J Surg, 1990, 160(5):485-487.
3. Chauhan A, Mehrotra M, Bhatia PK, et al. Day care laparoscopic cholecystectomy:a feasibility study in a public health service hospital in a developing country[J]. World J Surg, 2006, 30(9):1690-1695.
4. Labaille T, Mazoit JX, Paqueron X, et al. The clinical efficacy and pharmacokinetics of intraperitonealropivacaine for laparoscopiccholecystectomy[J]. Anesth Analg, 2002, 94(1):100-105.
5. Proske JM, Dagher I, Revitea C, et al. Day-case laparoscopic cholecystectomy:results of 211 consecutive patients[J]. Gastroenterol Clin Biol, 2007, 31(4):421-424.
6. Bona S, Monzani R, Fumagalli Romario U, et al. Outpatient laparoscopic cholecystectomy:a prospective study of 250 patients[J]. Gastroenterol Clin Biol, 2007, 31(11):1010-1015.
7. Chang SK, Tan WB. Feasibility and safety of day surgery laparoscopic cholecystectomy in a university hospital using a standard clinicalpathway[J]. Singapore Med J, 2008, 49(5):397-399.
8. Calland JF, Tanaka K, Foley E, et al. Outpatient laparoscopic cholecystectomy:patient outcomes after implementation of a clinical pathway[J]. Ann Surg, 2001, 233(5):704-715.
9. Chok KS, Yuen WK, Lau H, et al. Outpatient laparoscopic cholecystectomy in Hong Kong Chinese--an outcome analysis[J]. Asian J Surg, 2004, 27(4):313-316.
10. Bueno Lledó J, Planells Roig M, Arnau Bertomeu C, et al. Outpatient laparoscopic cholecystectomy:a new gold standard for cholecystectomy[J]. Rev Esp Enferm Dig, 2006, 98(1):14-24.
11. Sinha S, Munikrishnan V, Montgomery J, et al. The impact of patient-controlled analgesia on laparoscopic cholecystectomy[J]. Ann R Coll Surg Engl, 2007, 89(4):374-378.
12. Psaila J, Agrawal S, Fountain U, et al. Day-surgery laparoscopic cholecystectomy:factors influencing same-day discharge[J]. World J Surg, 2008, 32(1):76-81.
13. Parvaiz MA, Hafeez R. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy[J]. Br J Surg, 2006, 93(5):639-640.
14. Lam D, Miranda R, Hom SJ. Laparoscopic cholecystectomy as an outpatient procedure[J]. Am Coll Surg, 1997, 185(2):152-155.
15. Lillemoe KD. Laparoscopic cholecystectomy as a "true" outpatient procedure:initial experience in 130 consecutive patients[J]. Gastrointest Surg, 1999, 3(1):44-49.
16. Mjaland O, Raeder J, Aasboe V, et al. Outpatient laparoscopic cholecystectomy[J]. Br J Surg, 1997, 84(7):958-961.
17. Skattum J, Edwin B, Trondsen E, et al. Outpatient laparoscopic surgery:feasibility and consequences for education and health care costs[J]. Surg Endosc, 2004, 18(5):796-801.
18. Voitk AJ, Tsao SG, Ignatius S. The tail of the learning curve for laparoscopic cholecystectomy[J]. Am J Surg, 2001, 182(3):250-253.
19. Jain PK, Hayden JD, Sedman PC, et al. A prospective study of ambulatory laparoscopic cholecystectomy:training economic, and patient benefits[J]. Surg Endosc, 2005, 19(8):1082-1085.
20. 吴志明, 娄建平, 代明盛, 等.一日腹腔镜胆囊切除术26例分析[J].腹腔镜外科杂志, 2008, 13(5):434-435.
21. 沈火剑, 李可为, 季福, 等.日间腹腔镜胆囊切除术的临床应用分析[J].肝胆胰外科杂志, 2011, 23(1):43-45.
22. 徐靖, 赵永捷, 江涛, 等.过夜腹腔镜胆囊切除术分析68例[J/CD].中华腔镜外科杂志:电子版, 2011, 4(6):456-460.
23. 嵇武, 丁凯, 王丹, 等.门诊腹腔镜胆囊切除术与住院腹腔镜胆囊切除术的对照研究[J].医学研究所学报, 2010, 23(3):258-262.
24. 李可为, 丁俊, 陈涛, 等.日间腹腔镜胆囊切除25例分析[J].肝胆胰外科杂志, 2010, 22(1):48-49.
25. 李关平, 罗艳霞, 雷静, 等.腹腔镜胆囊切除术开展日间手术的可行性探讨[J].现代预防医学, 2010, 37(23):4576-4577.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Advantage of Ambulatory Laparoscopic Cholecystectomy

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