Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Fashun ^1,2 , ZHONG Kai ^1,2 , Mureaihemaitijiang•Mutalifu ^1,2 , ZHENG Xiaojie ³ , JIANG Tiemin ^1,2 , RAN Bo ^1,2 , GUO Qiang ^1,2 , ZHANG Ruiqing ^1,2 , SHAO Yingmei ^1,2 ,  Tuerganaili• Aji ^1,2

1. Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;
2. Xinjiang Uygur Autonomous Region Hydatid and Hepatobiliary Disease Clinical Medicine Research Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;
3. Department of Discipline Construction, Teaching and Research Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding author：

Tuerganaili• Aji, Email: tuergan78@sina.com

Keywords：

gallbladder disease; ambulatory surgery; laparoscope; cholecystectomy; curative effect

DOI：

10.7507/1007-9424.202010003

Video：

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Objective To evaluate and analyze the clinical effect of ambulatory surgery applied to laparoscopic cholecystectomy (LC).Methods The patients who underwent LC in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to February 2019 were collected, then were assigned to ambulatory surgery applied to LC group (ALC group) and conventional LC group (CLC group) according to the admission process mode. The patients in the ALC group received LC in the ambulatory ward and the patients in the CLC group received LC in the conventional ward. The preoperative waiting time, postoperative gastrointestinal recovery time, postoperative 6 h pain score, total hospitalization time, total hospitalization cost, patient satisfaction, and postoperative complications were compared between the two groups.Results A total of 433 patients underwent LC were included in this study, including 176 patients in the ALC group and 257 patients in the CLC group. There were no significant differences in the age, gender, type of gallbladder diseases, etc. between the two groups (P>0.05) except body mass index (P<0.05). There was no perioperative death in the two groups. One patient converted to laparotomy in the CLC group. Compared with the CLC group, the preoperative waiting time, postoperative gastrointestinal recovery time, and the total hospitalization time were shorter, the postoperative pain score was lower, the total hospitalization cost was less, and the satisfaction rate of patients was higher in the ALC group (P<0.05). There was 1 case of incision infection and 1 case of ascites in the operation area in the ALC group and CLC group, 1 case of fever in the ALC group and 3 cases of fever in the CLC group, respectively. There was no difference in the overall incidence of complications between the two groups (P>0.05). During the follow-up of 6 to 26 months, there was no readmission in both groups.Conclusion Patients who undergone LC based on ambulatory surgery mode recover quickly, and hospitalization cost is less, satisfaction rate is higher.

Citation： LU Fashun, ZHONG Kai, Mureaihemaitijiang•Mutalifu, ZHENG Xiaojie, JIANG Tiemin, RAN Bo, GUO Qiang, ZHANG Ruiqing, SHAO Yingmei, Tuerganaili• Aji. Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 856-860. doi: 10.7507/1007-9424.202010003 Copy

1.	马建伟, 杨晓军, 张芙莉, 等. 基于加速康复外科理念的无痛腹腔镜胆囊切除术的临床研究. 中国普外基础与临床杂志, 2016, 23(5): 581-585.
2.	Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg, 1990, 160(5): 485-487.
3.	Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
4.	马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
5.	中华医学会外科学分会中华医学会麻醉学分会. 加速康复外科中国专家共识及路径管理指南(2018 版). 中国实用外科杂志, 2018, 38(1): 1-20.
6.	Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
7.	Šoltés V, Gavurová B. The possibilities of day surgery system development within the health policy in Slovakia. Health Econ Rev, 2014, 4(1): 35.
8.	俞卫锋. 浅谈日间手术模式. 中华麻醉学杂志, 2016, 36(5): 513-514.
9.	姜华, 李云涛, 刘雁军, 等. 加速康复外科在择期结直肠手术中的评估. 中国普外基础与临床杂志, 2016, 23(8): 1011-1017.
10.	徐成, 吐尔干艾力·阿吉, 郭强, 等. 加速康复外科在日间病房内镜逆行胰胆管造影治疗胆总管结石中的应用. 中华普通外科学文献(电子版), 2019, 13(3): 213-218.
11.	Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
12.	谭黄业, 樊献军, 张力峰, 等. 快速康复外科理念指导下的腹腔镜胆囊切除术135例. 解放军医药杂志, 2011, 23(3): 30-32.
13.	Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
14.	刘洋, 马洪升, 李志超, 等. 5 520 例日间手术的安全和质量评价. 中国普外基础与临床杂志, 2015, 22(12): 1477-1481.
15.	李龙, 焦作义, 罗长江. 日间手术腹腔镜胆囊切除术疗效和安全性的Meta分析. 中华普通外科学文献(电子版), 2018, 12(6): 444-450.
16.	郭强, 吐尔干艾力·阿吉, 钟锴, 等. 加速康复外科理念在日间腹腔镜阑尾切除术中的应用效果研究. 中华全科医师杂志, 2019, 18(8): 760-764.
17.	Subirana Magdaleno H, Caro Tarragó A, Olona Casas C, et al. Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial. Cir Esp, 2018, 96(2): 88-95.
18.	Coelho JCU, Dalledone GO, Martins Filho EL, et al. Feasibility of routine ambulatory laparoscopic cholecystectomy in Brazil. JSLS, 2019, 23(2): e2019.00016.

1. 马建伟, 杨晓军, 张芙莉, 等. 基于加速康复外科理念的无痛腹腔镜胆囊切除术的临床研究. 中国普外基础与临床杂志, 2016, 23(5): 581-585.
2. Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg, 1990, 160(5): 485-487.
3. Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
4. 马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
5. 中华医学会外科学分会中华医学会麻醉学分会. 加速康复外科中国专家共识及路径管理指南(2018 版). 中国实用外科杂志, 2018, 38(1): 1-20.
6. Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
7. Šoltés V, Gavurová B. The possibilities of day surgery system development within the health policy in Slovakia. Health Econ Rev, 2014, 4(1): 35.
8. 俞卫锋. 浅谈日间手术模式. 中华麻醉学杂志, 2016, 36(5): 513-514.
9. 姜华, 李云涛, 刘雁军, 等. 加速康复外科在择期结直肠手术中的评估. 中国普外基础与临床杂志, 2016, 23(8): 1011-1017.
10. 徐成, 吐尔干艾力·阿吉, 郭强, 等. 加速康复外科在日间病房内镜逆行胰胆管造影治疗胆总管结石中的应用. 中华普通外科学文献(电子版), 2019, 13(3): 213-218.
11. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
12. 谭黄业, 樊献军, 张力峰, 等. 快速康复外科理念指导下的腹腔镜胆囊切除术135例. 解放军医药杂志, 2011, 23(3): 30-32.
13. Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
14. 刘洋, 马洪升, 李志超, 等. 5 520 例日间手术的安全和质量评价. 中国普外基础与临床杂志, 2015, 22(12): 1477-1481.
15. 李龙, 焦作义, 罗长江. 日间手术腹腔镜胆囊切除术疗效和安全性的Meta分析. 中华普通外科学文献(电子版), 2018, 12(6): 444-450.
16. 郭强, 吐尔干艾力·阿吉, 钟锴, 等. 加速康复外科理念在日间腹腔镜阑尾切除术中的应用效果研究. 中华全科医师杂志, 2019, 18(8): 760-764.
17. Subirana Magdaleno H, Caro Tarragó A, Olona Casas C, et al. Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial. Cir Esp, 2018, 96(2): 88-95.
18. Coelho JCU, Dalledone GO, Martins Filho EL, et al. Feasibility of routine ambulatory laparoscopic cholecystectomy in Brazil. JSLS, 2019, 23(2): e2019.00016.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy

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