Laparoscopic Cholecistectomy in day surgery: preliminary experience of first 80 consecutive cases.

Laparoscopic Cholecystectomy (LC) represents today the gold standard for the treatment of cholelithiasis (CL). The reported average post-operative hospital stay is 2.6 days. Day Surgery (DS) LC has been therefore suggested. Methods: Our treatment protocol for LC in DS includes age up to 65 years, BMI _ 35, no major contraindications for the general anesthesia (ASA I or II) and no acute complications of CL. Between July 2004 and July 2007, 80 consecutive patients (pt) underwent DS LC. They were 27 males and 53 females, age ranging between 15 and 63 years. Patient motivations and home support was also investigated. They were admitted at 07:00. A 3-trocar technique was always used. By 14:00 a soup is served and pt is allowed to walk. At 16:00 serum RBC, total and direct bilirubin, amylase and lipase are checked. At 18:00 the patient is discharged with dietary instruction, drug prescription, and the telephone numbers of the operative unit. Result: All the procedures were completed laparoscopically with a mean time of 38 min. Only 3 (4.1%) required overnight hospitalization for important nausea and vomiting. All patient but one expressed their satisfaction for this care regimen. Discussion: The ambulatory LC is justificated by simplification of the procedure, reduction of management costs even over one-day surgery regimen and also by reduct impact upon patients’ lifestyle.