Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit? A. Martínez Vieira, F. Docobo Durántez, J. Mena Robles. Abstract. MOORE, John Henry et al. Ambulatory laparoscopic cholecystectomy: a cost-efficient model of laparoscopic surgery. rev. colomb. cir. [online]. Download Citation on ResearchGate | Colecistectomía laparoscópica ambulatoria | SUMMARY Objective: We present our experience in lap- aroscopic .
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Routine day-case laparoscopic cholecistectomy.
Rev Esp Enferm Dig ; 93 4: Variables such as doubt or insecurity lapaorscopica patients cklecistectomia discharge can be important factors when it comes to deciding on admission. Criteria necessary for inclusion in this program of outpatient laparoscopic cholecystectomy included: However, in the Spanish health-care system, which is in need of public beds in most regions, reductions in the hospitalization stay are also important besides savings, so that beds may be put to good use for other patients, which may be achieved via MOS programs including well trained teams in outpatient LC for feasible cases.
Nowadays, for many authors, laparoscopic surgery for the treatment of uncomplicated biliary lithiasis is, along with the treatment of groin hernia, the laparoscopic procedure that can be carried out with greater colecistectomja and effectiveness on an outpatient basis 6,7.
Colecistectomía laparoscópica y cirugía ambulatoria
Andalusian Health Service from a surgical waiting list. Hospital 12 de Octubre. Laparoscopic cholecistectomy versus mini-laparotomy cholecistectomy. Surg Endosc ; Patients’ experiences of laparoscopic cholecistectomy in day surgery.
Anesthesia for laparoscopy with emphasis on outpatient laparoscopy. The colecistectomja of these studies is relative when compared to downpouring experience pointing that laparoscopy provides a far more benign immediate postoperative time.
Laparoscopic cholecystectomy in the treatment of biliary lithiasis: Colecustectomia, it is necessary that discharge, and the knowledge of how to continue recovery at lapraoscopica, is accepted by the patient, and instructions to follow must be very clearly laid out for both patients and their families. Laparoscopic cholecystectomy was carried out in all cases following the European technique. How-ever, regardless of what surveys on satisfaction and perceived service quality indicate, discharging less than 24 hours after the procedure does not decrease quality or imply a greater number of complications in the following month.
Thus, savings incurred will have a tremendous impact on health-care expense.
Although many comparative studies exist on all sorts of partial aspects that clear-ly reveal the benefits of LC -from classic morbidity and mortality, and hospital stay studies to sophisticated studies on- say -post-procedural immune response- only two prospective, randomized, single-blind studies compared laparoscopic versus open cholescystectomy 1,2and none showed clearly significant differences for either procedure.
The level of complexity of procedures that can be carried out in a DSU is increasing. In recent years it may be safely stated that a major change in the understanding of surgery has taken place with laparoscopic surgery in the late s.
Eighty one out of 91 patients who underwent laparoscopic cholecystectomy during year have been included in this study. Predicting failure of outpatient laparoscopic cholecystectomy. The latter authors reported in on their experience along 4 years of outpatient LC in this same journal 5and were understandably considered a pioneer group for LC in MOS in our country.
Its feasibility has been demonstrated in all settings and differing countries with rather similar results World J Surg ; 26 9: Compared to inpatient surgery, it reduces the time a patient spends in hospital and therefore entails less interference in daily and working life 4.
The aim of the present study was to analyse clinical and surgical factors in patients who underwent laparoscopic cholecystectomy in a DSU, which could be determinants in deciding to discharge patients on the same day of the procedure DSU programme or to discharge them after 24 hours of hospital stay SSS Unit.
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The histopathological study of the excised gallbladder, whose results were available approximately twenty days after the procedure, reported: Ann Surg ; Use of ondansetron for prevention of postoperative nausea and vomiting in major ambulatory surgery. We should not be oblivious regarding the fact that the so-called “surgeon factor” may never be blind -and is difficult to assess- and therefore double-blind studies are not feasible. Rev Esp Anestesiol Reanim ; 43 8: Rev Esp Enferm Dig ; 96 7: Lau H, Brooks DC.
Group A patients were discharged between 24 and 48 hours after the procedure and required a one-day stay in hospital, and group B ,aparoscopica were discharged in less than 24 hours, without hospitalization. The term DSU combines processes complementary to surgery performed using any type of anesthesia that require less intensive postoperative care and are of short duration; therefore patients do not need to stay in the hospital and can be discharged a few hours after the procedure 1.
Indeed, the linking of technologic development circumstances to the will of a number of surgeons to offer less damaging surgery led to the notion of “minimally aggressive surgery”, in which laparoscopic surgery is colscistectomia.
Quality of life GIQLI and laparoscopic cholecystectomy usefulness in patients with gallbladder dysfunction or chronic non-lithiasic biliary pain chronic acalculous cholecystitis. Cir Esp ; Mean discharge time was 10 hours after the procedure. All of them satisfied the following criteria: Other complications that lead to unexpected extension of the hospital stays bleeding, drainage, etc. Patients were divided into two groups A and Bdepending on the time when they were discharged.
The problem is that bladder and bile duct motility is difficult to acknowledge in daily practice 7and disorders may be in combination with other gastrointestinal motility abnormalities 8.
All patients followed the normal procedures establi-shed by the DSU: In fact, initial distrust regarding this way of surgery has led to a careful analysis of its results which we are convinced was unparalleled before for surgical techniques.
The same goes for private surgery, but regarding public health-care, a universal, free-of-charge model such as the Spanish one is mainly concerned in hospital stay reduction in addition to reduced costs per procedure, in an attempt to free coelcistectomia beds for other procedures and send patients home upon surgery completion.
Feasibility and safety of day care laparoscopic cholecistectomy in a developing country. Rico Selas and A.