Day case laparoscopic cholecystectomy

ABSTRACT

Day case laparoscopic cholecystectomy [DC-LC] is being practised in the USA and at sporadic centres in the UK including our department. The aim was to evaluate the initial experience of DC-LC at the unit. Prospectively collected data was analysed retrospectively. The case notes of all patients were retrieved from the medical records and reviewed individually. Standard laparoscopic cholecystectomy was performed. All patients had anti-DVT prophylaxis [pneumatic compression and enoxaparin], per-operative antibiotic, oro-gastric tube, paracetamol suppository and local anaesthetic to all wounds. They were discharged the same day. The end point was 6-week follow-up [86% overall]. Over a 32-month period, 164 consecutive patients with symptomatic cholelithiasis and ASA score of III or less were included. MF was 15 and median age 43y. There were two conversions. The direct admission rate [DAR] was 26/164 [14%]. The indication for direct admission included observation alone [7/26], wound pain [6/26], nausea [3/26], suction drain [2/26] and operation in the afternoon [2/26]. Six [3.6%] required re-admission. One had a cystic artery pseudo-aneurysm presenting with colonic bleeding and anot her with an injury to CBD. One had post-op mild pancreatitis and three had wound pain and bruising. DC-LC is safe and feasible in non-acute patients with symptomatic cholelithiasis