Day Case Laparoscopic Cholecystectomy

Background: Day case laparoseopic cholecystectomy (DC-LC) is being practised in the USA and at spradic centres in the UK including our department. The aim was to evaluate the initial experience of DC-LC at the unit. Patients & methods: Prospectively collected data was analysed retrospectively. The case notes of all patients We re retrieved from the medical records and reviewed individually. Standard laparoscopic cholecystectomy was performed. All patients had anti-DVT prophylaxis (pneumatic compression and enoxaparin), per-operative antibiotic, oro-gastric tube, paracetamol suppository and local anaesthetic to all wounds. They were discharged the same day. The end point was 6-readweek follow-up (86% overall). Results: Over a 32-month period, 164 consecutive patients with symptomatic cholelithiasis and ASA score of III or less were included. M:F as 1:5 and median age 43y. There were two conversions. The direct admission rate (DAR) was 26/164 (14%). The indication for direct admission included observation alone (7/26), wound pain (6/26), nausea (3/26), suction drain (2/26) and operation in the afternoon (2/26). Six (3.6%) required re-admission. One had a cystic artery pseudo-aneurysm presenting with colonic bleeding and another with an injury to CBD. One had post-op mild pancreatitis and three had wound pain and bruising Conclusion DC-LC is safe and feasible in non-acute patients with symptomatic cholelithiasis.