Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit? A. Martínez Vieira, F. Docobo Durántez, J. Mena Robles. Abstract. MOORE, John Henry et al. Ambulatory laparoscopic cholecystectomy: a cost-efficient model of laparoscopic surgery. rev. colomb. cir. [online]. Download Citation on ResearchGate | Colecistectomía laparoscópica ambulatoria | SUMMARY Objective: We present our experience in lap- aroscopic .
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Surg Endosc ; One of them developed an umbilical hernia across the trocar incision and another an infection of the surgical wound.
Postgrad Med J ; Dig Liver Dis ; 35 Supl. During the immediate post-operative period, monitoring was maintained in a recovery room; patients were then taken to hospital laparosckpica following anesthetic assessment, where normal nursing practices and a follow-up by the surgeon were carried out, the latter being also responsible for hospital discharge.
Am J Surg ; 6: Ann Surg ; The level of complexity of procedures that can be carried out in a DSU is increasing. Although many comparative studies exist on all sorts of partial aspects that clear-ly reveal the benefits of LC -from classic morbidity and mortality, and hospital stay studies to sophisticated studies on- say -post-procedural immune response- only two prospective, randomized, single-blind studies compared laparoscopic versus open cholescystectomy 1,2and none showed clearly significant differences for either procedure.
The problem is that bladder and bile duct motility is difficult to acknowledge in daily practice 7and disorders may be in combination with other gastrointestinal motility abnormalities 8. Similarly, a small number of failures from intra- or postoperative complications exist, which will diminish as experience is gain-ed in both patient selection and surgical, anesthetic and nursing management scheduling. It is basically determined by the traditional belief that a longer period of health care provides better results than an outpatient regimen.
How-ever, regardless of what surveys on satisfaction and perceived service quality indicate, discharging less than 24 hours after the procedure does not decrease quality or imply a greater number of complications in the following month.
Laparoscopic cholecystectomy was carried out in all cases following the European technique. Factors of clinical significance which determined discharge after 24 hours included: Even so, many patients choose to stay in hospital one day for no apparent reason, since they prefer the direct observation and care of professionals.
The latter authors reported in on their experience along 4 years of outpatient LC in this same journal 5 xolecistectomia, and were understandably considered a pioneer group for LC in MOS in our country. Tratamiento de la hernia inguinocrural.
Eighty one out of 91 patients who underwent laparoscopic cholecystectomy during year have been included in this study.
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Routine day-case laparoscopic cholecistectomy. Lastly, it is necessary that discharge, and the knowledge of how to continue recovery at home, is accepted by the patient, and instructions to follow must be very clearly laid out for both patients and their families.
Cir Esp ; One group performed the procedure habitually and on an outpatient basis in most cases, whereas the other group performed the technique rather sporadically among their scheduled standard procedures.
In any case LC is no doubt an excellent procedure, currently the gold-standard in the treatment of symptomatic cholelithiasis, which may be performed as MOS in a high number of patients. We conclude that outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high level of acceptance. In both groups of patients, we analyzed: For the remaining 33 patients Incidents and complications arose in 9 patients Patients were divided into two groups A and Bdepending on the time when they were discharged.
In general, events emerging in the early postoperative period can be considered a statistically significant determinant for patient admission. Anesthesiol Clin North America ; 19 1: But quality management is as important regarding “offered quality” as regarding “perceived quality”, and this is often harder to convey so that early discharged patients perceive it, be it because of fear even in the absence of complications or because of a magnification of events that obviously might also have developed should the patient have stayed in hospital.
Use of ondansetron for prevention of postoperative nausea and vomiting in major ambulatory surgery.
Br J Surg ; The accounting peculiarities of the Spanish health-care system makes laparoscopicx very difficult to quantify presumed savings versus inpatient surgery, since the cost lapzroscopica to set up a home care system infrastructure and that of readmissions should have to be subtracted from reduced costs per bed and day. A prophylactic antibiotic, cefazoline, was administered, and a dressing was applied to the lower limbs of patients with distal vein problems or obesity.
¿Me puedes recomendar una dieta para después de la extracción de la vesícula? – Mayo Clinic
Thus, patients who are at high-risk regarding anes-thesia may not be included, where in addition to potential surgical complications an eye must colecistetomia kept on potential anesthesia-related complications. Rev Esp Enferm Dig ; 93 4: Regarding the sex variable, a larger percentage of females, as opposed to males, required hospitalization. Lau H, Brooks DC.
We would like to stop here at any rate to superficially analyze colecistectmoia differences amongst cultures and health-care models with respect to major outpatient surgery MOS.
Patients’ experiences of laparoscopic cholecistectomy in day surgery. Rev Esp Enferm Dig ; When it is necessary for patients to have a recovery period of more than 24 hours in hospital, with the subsequent increase in costs, we are colecistectoma with the concept known as Short Stay Surgery SSS.
Colecistectomía laparoscópica y cirugía ambulatoria
Br J Surg ; Ann Surg ; But this advance means it will be necessary for patients to have a longer period of recovery, with a subsequent increase in costs. A prevention of such incidents is the best way to avoid hospital stays.
Thus, savings incurred will have a tremendous impact on health-care expense.