Cholécystectomie coelioscopique ambulatoire: Expérience dun an sur des patients non sélectionnés

This study reviews our experience with outpatient laparoscopic cholecystectomy (CCA) to evaluate the benefits of this approach to routine clinical practice. Patients and methods: Of 217 consecutive patients undergoing laparoscopic cholecystectomy over a one-year period (2002-2003) at our university medical center, 151 were selected for same day surgery and discharge according to the following selection criteria: non-urgent surgery, no major co-morbidities, domicile within one hour of the hospital. Patients were typically discharged the afternoon of their surgery if their clinical condition was stable. Results: Of 151 planned outpatient CCA's, 122 (81%) were discharged on the day of surgery. Of these, 16 had a post-operative complication and three required readmission; no patient required reoperation. Univariate analysis revealed three factors predictive of failure of the outpatient strategy: age > 65 (p=0.015), operative duration (p<0.0001), and surgical start time after 11 am (p<0.0001). Conclusions: Outpatient laparoscopic cholecystectomy can be routinely accomplished in unselected patients in an academic center. The low rate of in-patient admission is acceptable. The out-patient strategy for laparascopic cholecystectomy allows for a reduction in waiting time at our institution.