Day-case Laparoscopic Cholecystectomy Without Overnight Hospitalization：Experience of 78 Cases / 中国微创外科杂志

Objective To explore the feasibility and safety of day surgery laparoscopic cholecystectomy . Methods From January 2015 to June 2015, 78 cases of day-case laparoscopic cholecystectomy were performed in our hospital .The clinical data were retrospectively reviewed .These patients were diagnosed as having cholelithiasis or cholecystic poypus .They had no severe heart or lung diseases, no history of epigastric operation , and agreed to accept day-case laparoscopic cholecystectomy without overnight hospitalization. Results Of the 78 patients, 74 patients (94.9%) successfully accepted the surgery and were discharged no more than 4 h after surgery, including 2 patients with combined laparoscopic transcyctic common bile duct exploration ( LTCBDE).The remaining 4 patients (5.1%) were admitted for overnight hospital stay , including 1 patient (1.3%) with Mirizzi syndrome type Ⅰwho was given abdominal drainage , 2 patients (2.6%) with severe nausea and vomit , 1 patient (1.3%) with airway obstruction after operation.All the 4 patients were discharged within 24 h after the surgery.The operating time was 35-152 min (mean, 80.0 ±19.7 min).The hospitalization expenses was 5688-9768 yuan (mean, 8318.0 ±848.5 yuan).The hospitalization time was 5.6-23.9 h (median, 7.4 h).Postoperative follow-up at the day of surgery, the first and the seventh postoperative day showed that none of the patients suffered from severe complications . Conclusion Day-case laparoscopic cholecystectomy is safe and feasible , on the basis of strictly selected patients , experienced surgeons , and close cooperation with anesthetists and nurses .

Laparoscopic operation in the treatment of aged patients with cholelithiasis / 国际外科学杂志

Objectives The purpose of this study was to investigate the characteristics of the aged patients with cholelithiasis and summarize the clinical application experiences.Methods A retrospective analysis was performed on aged patients with cholelithiasis treated by laparoscopic operation between Apr.2012 and Apr.2015.Studies which provided outcome data on aged patients, subjected to laparoscopic operation were considered.Mortality, morbidity, cardiac and pulmonary complications were the outcome measures of treatment effect.Results Twenty-seven patients had cholecystolithiasis, of whom laparoscopic cholecystectomy was successfully performed in twenty-six cases and one case was changed to transabdominal operation.Among the fifty-four patients with suspected or confirmed biliary calculi, laparoscopic cholecystectomy + laparoscopic transcystic common bile duct exploration was successfully performed in forty-two cases and one case was changed to transabdominal operation.Six cases changed to cholecystectomy because of the diameter of the bile duct.Five patients who already had laparoscopic cholecystectomy received Ⅰ stage suturing of bile duct after the removal of the stones.Bile leak occurred in one case and pancreatitis occurred in three cases.Pneumonia occurred in three cases and one case was transmitted to the infection ward for further treatment.No severe procedure-related complication occurred.There was no significant difference in mortality, morbidity, cardiac and pulmonary complications.Conclusions Laparoscopic operation was acceptable for aged patients.Proper peri-operative management was essential to reduce the complications.