Discharge within 24 hours of elective cholecystectomy. The first 100 patients.

Discharge with 24 hours of elective cholecystectomy has proved to be an attainable goal for the vast majority of patients, without increasing risk. The clinical courses of the first 100 subjects (of 109 consecutive patients) to reach this goal were examined critically. Preservation of gastrointestinal function and immediate full enteral nutrition were major steps toward reduction of hospital dependency. Pain and the need for narcotics were reduced by careful patient instruction and wound infiltration with a long-acting local anesthetic. Preoperative hospitalization was eliminated by outpatient testing and admission for 29 subjects, who were admitted the day of surgery. This group's entire stay was only one day. Patients and family found the total regimen acceptable by independent review. Significant cost savings were realized as a fringe benefit.