Evaluation of patient safety and satisfaction in a program of ambulatory laparoscopic cholecystectomy program with expanded criteria

Autores de IIS La Fe

• Angela Sala Hernández

  Autor

• Pablo Granero Castro

  Autor

• Javier Maupoey Ibáñez

  Autor

• Rafael López Andújar

  Autor

Participantes ajenos a IIS La Fe

• Oron, EM
• Garcia-Dominguez, R
• Liedo, JB
• Cirion, JLI

Grupos

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Abstract

Introduction: The good results obtained with the implementation of ambulatory laparoscopic cholecystectomy programs have led to the expansion of the initial inclusion criteria. The main objective was to evaluate the results and the degree of satisfaction of the patients included in a program of laparoscopic cholecystectomy without admission, with expanded criteria. Methods: Observational study of a cohort of 260 patients undergoing ambulatory laparoscopic cholecystectomy between April 2013 and March 2016 in a third level hospital. We classified the patients into 2 groups based on compliance with the initial inclusion criteria of the outpatient program. Group I (restrictive criteria) includes 164 patients, while in group II (expanded criteria) we counted 96 patients. We compared the surgical time, the rate of failures in ambulatory surgery, rate of conversion, reinterventions and mortality and the satisfaction index. Results: The overall success rate of ambulatory laparoscopic cholecystectomy was 92.8%. The most frequent cause of unexpected income was for medical reasons. There was no statistically significant difference between the 2 groups for total surgery time, the rate of conversion to open surgery and the number of major postoperative complications Do not demostrate differences in surgical time, nor in the number of perioperative complications (major complications 1,2%), or the number of failures in ambulatory surgery, nor the number of readmissions between both groups. There was no death. 88.5% of patients completed the survey, finding no differences between both groups in the patient satisfaction index. The overall score of the process was significantly better in group II (P=.023). Conclusions: Ambulatory laparoscopic cholecystectomy is a safe procedure with a good acceptance by patients with expanded criteria who were included in the surgery without admission program. (C) 2018 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Laparoscopic cholecystectomy; Ambulatory major surgery; Ambulatory laparoscopic cholecystectomy; Selection criteria; Surgery without admision