Is outpatient laparoscopic cholecystectomy wise?

C. J. Saunders, B. F. Leary, Bruce Wolfe

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

The authors report a prospective analysis of their experience with 506 consecutive laparoscopic cholecystectomies to examine the appropriatenss of outpatient or same-day laparoscopic cholecystectomy. Thirty-eight patients experienced at least one postoperative complication. The complication was clinically evident or suspected in only 4 of these 38 patients within 8 h following surgery. Thirty-nine percent and 76% of complications were clinically detected at 24 and 48 h, respectively. Nausea and vomiting occurred among 32% of all patients on the day of operation and extended into the 1st postoperative day in 10%. Compared to predicted values, forced vital capacity was 61±5% 1 h postoperatively in 32 patients studied. At 6 and 24 h postoperatively, forced vital capacity was 63±7% and 66±7% respectively. Postoperative analgesic medication requirement was determined in 220 patients who were provided with a patient-controlled intravenous morphine analgesia machine with no basal rate. Consumption of morphine was highly variable but substantial on the day of operation: 17±16 mg. Most complications of laparoscopic cholecystectomy, including life-threatening complications, are not apparent by 8 h postoperatively and may not be apparent at 24 h. The potential for delay in the diagnosis and treatment of complications, variable but substantial analgesic requirements, impaired postoperative ventilation, and postoperative gastrointestinal dysfunction argue for the need to use great caution in selecting patients for outpatient laparoscopic cholecystectomy. Criteria are proposed to identify patients who are safest for outpatient laparoscopic cholecystectomy.

Original languageEnglish (US)
Pages (from-to)1263-1268
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume9
Issue number12
DOIs
StatePublished - Dec 1995
Externally publishedYes

Fingerprint

Laparoscopic Cholecystectomy
Outpatients
Vital Capacity
Morphine
Analgesics
Analgesia
Nausea
Vomiting
Ventilation

Keywords

  • ambulatory surgery
  • Laparoscopic cholecystectomy
  • Narcotic requirement
  • Pulmonary function

ASJC Scopus subject areas

  • Surgery

Cite this

Is outpatient laparoscopic cholecystectomy wise? / Saunders, C. J.; Leary, B. F.; Wolfe, Bruce.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 9, No. 12, 12.1995, p. 1263-1268.

Research output: Contribution to journalArticle

Saunders, C. J. ; Leary, B. F. ; Wolfe, Bruce. / Is outpatient laparoscopic cholecystectomy wise?. In: Surgical Endoscopy and Other Interventional Techniques. 1995 ; Vol. 9, No. 12. pp. 1263-1268.
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