Outpatient laparoscopic cholecystectomy and pain control: a series of 100 cases

Abstract

Introduction: We present our experience of 100 consecutive cases that 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 7.4h (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.

Keywords: Cholelithiasis; Cirugía mayor ambulatoria; Colecistectomía laparoscópica ambulatoria; Colelitiasis; Major ambulatory surgery; Outpatient laparoscopic cholecystectomy.