Outpatient Laparoscopic Cholecystectomy and Pain Control: A Series of 100 Cases

• Published in: Cirugia española (English ed.) 2015-03, Vol.93 (3), p.181-186
• Main Authors: Jiménez Fuertes, Montiel, Costa Navarro, David
• Format: Article
• Language: English
• Subjects: Cholelithiasis; Cirugía mayor ambulatoria; Colecistectomía laparoscópica ambulatoria; Colelitiasis; Major ambulatory surgery; Outpatient laparoscopic cholecystectomy; Surgery
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2013.04.014

Abstract Introduction We present our experience of 100 consecutive cases who underwent ambulatory cholecystectomy using a standard protocol of anesthesia and surgery. Patients and method Prospective study of 100 consecutive patients assessed in the surgery outpatient clinic in Torrevieja Hospital (September 2008–September 2009). Both anesthetic and surgical techniques were protocolized, standardized. The protocol included the use of intraperitoneal and parietal anesthesia. Results One hundred patients were included. Average age was 53 years and average surgical time was 29±12 min. Day-case surgery rate was 96%. Postoperative pain (VAS scale) was less than 4 in all cases. Six patients complained of nausea that eased with the administration of ev metoclopramide. Average length of stay in the day-case surgery unit was 7.4 h (maximum 9.6, minimum 7). Morbidity and mortality rates were 0%. No re-admission was registered and conversion rate was 0%. Postoperative follow-up was 100%. A total of 97% of the cases were fully satisfied with the procedure. Conclusion Ambulatory laparoscopic cholecystectomy is a feasible and safe technique. Postoperative pain has classically been the reason to not perform day-case surgery, but we achieved an excellent control by the combined use of local anesthetics and warm intraperitoneal saline solution.