Is outpatient cholecystectomy safe for the higher-risk elective patient ?

• Published in: Surgical endoscopy Vol. 11; no. 12; pp. 1147 - 1149
• Main Author: VOITK, A. J
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.12.1997
• Subjects: Acute Disease; Aged; Ambulatory Surgical Procedures; Anesthesia, Inhalation; Biological and medical sciences; Cardiovascular Diseases - complications; Chi-Square Distribution; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - methods; Cholecystitis - surgery; Elective Surgical Procedures; Female; Follow-Up Studies; Health Status; Hospitalization; Humans; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Patient Discharge; Patient Readmission; Postoperative Complications; Pulmonary Edema - etiology; Retrospective Studies; Risk Factors; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Cholecystectomy; Human; High risk; Indication; Patient; Laparoscopy; Biliary tract disease; Result; Surgery; Digestive diseases; Surgical approach; Gallbladder; Endoscopy; Ambulatory
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004649900557

This study was done to determine the safety of outpatient cholecystectomy for the higher-risk patient. All patients over age 70 or with American Society of Anesthesiologists physical status classification of 3 or greater, from all 515 consecutive patients booked for elective cholecystectomy between April 1, 1994, and March 31, 1996, were reviewed. Of 85 higher-risk patients, 77 were booked as outpatients. Sixty-one were successfully completed as outpatients, with no complications or readmissions related to their outpatient status. Of 24 admitted patients, 15 had specific indications for hospitalization. Nine were admitted for reasons of "precaution." One of these developed a complication, possibly related to her inpatient status. The other eight could have been managed as outpatients. Outpatient cholecystectomy is safe for the higher-risk patient. Patients who recover uneventfully from surgery can be discharged without harmful effects. "Precautionary" hospitalization may be harmful.