Uirá Fernandes Teixeira1, Marcos Bertozzi Goldoni1, Mayara Christ Machry1, Pedro Ney Ceccon1, Paulo Roberto Ott Fontes1, Fábio Luiz Waechter1. 1. Divisão de Cirurgia Hepato-Pancreato-Biliar, Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital Santa Casa de Misericórdia de Porto Alegre, RS, Brasil., Universidade Federal de Ciências da Saúde de Porto Alegre, Divisão de Cirurgia Hepato-Pancreato-Biliar, Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital Santa Casa de Misericórdia de Porto Alegre, RS , Brazil.
Abstract
BACKGROUND: - Laparoscopic cholecystectomy is the treatment of choice for gallstone disease, and has been perfomed as an outpatient surgery in many Institutions over the last few years. OBJECTIVE: - This is a retrospective study of a single center in Brazil, that aims to analyze the outcomes of 200 cases of ambulatory laparoscopic cholecystectomy performed by the same Hepato-Pancreato-Biliary team, evaluating the safety and cost-effectiveness of the method. METHODS: - Two hundred consecutive patients who underwent elective laparoscopic cholecystectomy were retrospectively analyzed; some of them underwent additional procedures, as liver biopsies and abdominal hernias repair. RESULTS: - From a total of 200 cases, the outpatient surgery protocol could not be carried out in 22 (11%). Twenty one (95.5%) patients remained hospitalized for 1 day and 1 (4.5%) patient remained hospitalized for 2 days. From the 178 patients who underwent ambulatory laparoscopic cholecystectomy, 3 (1.7 %) patients returned to the emergency room before the review appointment. Hospital cost was on average 35% lower for the ambulatory group. CONCLUSION: - With appropriate selection criteria, ambulatory laparoscopic cholecystectomy is feasible, safe and effective; readmission rate is low, as well as complications related to the method. Cost savings and patient satisfaction support its adoption. Other studies are necessary to recommend this procedure as standard practice in Brazil.
BACKGROUND: - Laparoscopic cholecystectomy is the treatment of choice for gallstone disease, and has been perfomed as an outpatient surgery in many Institutions over the last few years. OBJECTIVE: - This is a retrospective study of a single center in Brazil, that aims to analyze the outcomes of 200 cases of ambulatory laparoscopic cholecystectomy performed by the same Hepato-Pancreato-Biliary team, evaluating the safety and cost-effectiveness of the method. METHODS: - Two hundred consecutive patients who underwent elective laparoscopic cholecystectomy were retrospectively analyzed; some of them underwent additional procedures, as liver biopsies and abdominal hernias repair. RESULTS: - From a total of 200 cases, the outpatient surgery protocol could not be carried out in 22 (11%). Twenty one (95.5%) patients remained hospitalized for 1 day and 1 (4.5%) patient remained hospitalized for 2 days. From the 178 patients who underwent ambulatory laparoscopic cholecystectomy, 3 (1.7 %) patients returned to the emergency room before the review appointment. Hospital cost was on average 35% lower for the ambulatory group. CONCLUSION: - With appropriate selection criteria, ambulatory laparoscopic cholecystectomy is feasible, safe and effective; readmission rate is low, as well as complications related to the method. Cost savings and patient satisfaction support its adoption. Other studies are necessary to recommend this procedure as standard practice in Brazil.
Authors: Júlio Cezar Uili Coelho; Giuliano Ohde Dalledone; Eduardo Lopes Martins Filho; Eduardo José Brommelstroet Ramos; Marco Aurélio Roeder da Costa; Omar O H M de Loyola E Silva Journal: JSLS Date: 2019 Apr-Jun Impact factor: 2.172
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