腹腔镜胆囊切除术作为一项日间手术的结果

R. Ramzan, Danish Afzal, A. Butt, M. Hassaan, M. Sarwar, S. Naqi
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摘要

导读:胆结石疾病是一种由胆囊结石发展而引起的疾病,通常表现为上腹部疼痛,是消化系统最常见的疾病之一。它可以通过手术切除胆囊,通过开放胆囊切除术或腹腔镜胆囊切除术(关键孔手术)治疗;后者允许患者在手术当天出院,这一概念被称为即日手术。材料和方法:这是一个描述性病例系列,其中100例患者通过非概率连续抽样选择。采用纳入和排除标准。在施行腹腔镜胆囊切除术前,由麻醉师和外科顾问医师对患者进行评估。手术后,鼓励患者摄入液体,并在达到出院标准后立即出院。意外的夜间入院决定了本研究的结果。结果:86%患者手术当日出院,14%患者术后留宿。没有再入院,但有3%的患者进行了意外咨询。年龄和BMI对住院患者的分层后值有统计学意义,而性别和症状持续时间的分层后值无统计学意义。结论:患者选择是影响腹腔镜胆囊切除术疗效的重要因素,是一种有效的手术方法。本研究将有助于腹腔镜胆囊切除术作为一种日常手术,是减少医疗资源负担的有效途径。关键词:胆囊切除术,日间腹腔镜胆囊切除术(DCLC),腹腔镜手术(LC)
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Outcome of Laparoscopic Cholecystectomy as a Day Case Procedure
Introduction: Gallstone disease, a condition caused by the development of stones in gall bladder, usually presents with pain in upper abdomen, is one of the most common diseases of digestive system. It can be treated by the surgical removal of gall bladder, either through open cholecystectomy or by laparoscopic cholecystectomy (key hole surgery); the latter allows patients to be discharged from hospital on the day of their surgery, a concept known as day case surgery. Material and Methods: It was a descriptive case series in which 100 patients were selected through non probability, consecutive sampling. Inclusion and exclusion criteria were applied. Patients were assessed by anesthetist and consultant surgeon before undergoing laparoscopic cholecystectomy. After surgery, patients were encouraged intake of liquids and were discharged from the hospital as soon as they fulfilled the discharge criteria. Unplanned overnight admissions determined the outcome of this study. Results: 86% patients were discharged on the same day of surgery and 14% patients had an overnight stay after surgery. There were no readmissions but 3% of the patients presented for an unexpected consultation. Post stratification values of overnight admissions with age and BMI were found to be statistically significant while those for gender and duration of symptoms were found to be statistically insignificant. Conclusion: Patient selection is an important factor that affects the outcome of laparoscopic cholecystectomy, which is mostly an effective procedure. This study will help in the adoption of laparoscopic cholecystectomy as a day case procedure which is an effective way of reducing burden on health care resources. Keywords: Cholecystectomy, day case laparoscopic cholecystectomy (DCLC), laparoscopic surgery (LC).
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