Laparoscopic cholecystectomy in the ambulatory surgery setting.

Laparoscopic cholecystectomy is now a well-established alternative to open cholecystectomy. It is less invasive and recovery generally is quicker and less painful. Several articles have been published in support of outpatient laparoscopic cholecystectomy. The main benefits are cost savings and patient and surgeon convenience. The main obstacles, however, are patient reluctance and surgeons' concern about sending a patient home without benefit of professional supervision after abdominal surgery and a few hours of general anesthesia. A new approach, consisting of surgery in an Ambulatory Surgery Center (ASC) and overnight observation in a free-standing Post Surgery Recovery Center (PSRC), is presented; and the first 100 patients in the study are reported. Laparoscopic cholecystectomy in the ASC with overnight observation in the PSRC offers the advantages of outpatient surgery, namely, lower cost and greater patient and surgeon satisfaction, while allowing the safety and convenience of remaining under professional supervision for the first 24 hours.