Outpatient laparoscopic cholecystectomy:: one year experience in unselected patients

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 nine at our institution.