Abstract
Introduction: Ambulatory surgeries are on the rise in recent years and can offer benefits to patients as well as healthcare providers. Laparoscopic cholecystectomy is one of the procedures commonly done in an ambulatory setting, in some European countries. This study aims to gather patients’ perceptions towards ambulatory cholecystectomy after undergoing laparoscopic cholecystectomy in an inpatient setting. Methods: A total of 300 patients from two different hospitals in Germany received a postoperative questionnaire aimed at evaluating their willingness to undergo an ambulatory surgery. Surgeries were performed between January 1, 2017, and July 11, 2018. Operation setting (acute vs. elective), ASA classification, length of hospital stay, age, sex, living situation and location (city vs. rural), as well as status of employment were documented. Results: Overall, 23% of patients reported considering ambulatory laparoscopic cholecystectomy (ALC), while 77% rejected an ALC. Objections included fear of complications (69%), anticipated pain (65%), concerns about their living situation/home care (21%), other reasons (8%), nausea and vomiting (3.4%). Baseline characteristics of the participants provided no statistical significance on willingness to undergo ALC: acute versus elective (p = 0.22), ASA classification (p = 0.77), age ≥65 years versus <65 years (p = 0.60), gender (p = 0.07), living situation (p = 0.49), location (p = 0.15). Conclusion: There is a willingness for ALC, albeit still limited. Chosen criteria did not show a significant association for positive perception of ALC.
Journal Section:
Research Article
References
1.
Gutt
C
, Jenssen
C
, Barreiros
AP
, Götze
TO
, Stokes
CS
, Jansen
PL
, et al. [Updated S3-Guideline for Prophylaxis, Diagnosis and Treatment of Gallstones. German Society for Digestive and Metabolic Diseases (DGVS) and German Society for Surgery of the Alimentary Tract (DGAV) - AWMF Registry 021/008]
. Z Gastroenterol
. 2018
;56
(8
):912
–66
. 2.
Gutt
C
, Schläfer
S
, Lammert
F
. The treatment of gallstone disease
. Dtsch Arztebl Int
. 2020
;117
(9
):148
–58
. 3.
Kim
SS
, Donahue
TR
. Laparoscopic cholecystectomy
. JAMA
. 2018
;319
(17
):1834
. 4.
Agresta
F
, Campanile
FC
, Vettoretto
N
, Silecchia
G
, Bergamini
C
, Maida
P
, et al. Laparoscopic cholecystectomy: consensus conference-based guidelines
. Langenbecks Arch Surg
. 2015
;400
(4
):429
–53
. 5.
Steiner
CA
, Karaca
Z
, Moore
BJ
, Imshaug
MC
, Pickens
G
. Surgeries in hospital-based ambulatory surgery and hospital inpatient settings
. Rockville (MD)
: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs Agency for Healthcare Research and Quality (US)
; 2006
.6.
van Dijk
AH
, de Reuver
PR
, Besselink
MG
, van Laarhoven
KJ
, Harrison
EM
, Wigmore
SJ
, et al. Assessment of available evidence in the management of gallbladder and bile duct stones: a systematic review of international guidelines
. HPB Oxf
. 2017
;19
(4
):297
–309
. 7.
Tang
H
, Dong
A
, Yan
L
. Day surgery versus overnight stay laparoscopic cholecystectomy: a systematic review and meta-analysis
. Dig Liver Dis
. 2015
;47
(7
):556
–61
. 8.
Holguín-Ruacho
D
, Cervantes-Sánchez
CR
. Quality and patient satisfaction after ambulatory laparoscopic management of non-severe and uncomplicated gallbladder pathology
. Cir Cir
. 2019
;87
(6
):656
–61
. 9.
Aslet
M
, Yates
D
, Wasawo
S
. Improving the day case rate for laparoscopic cholecystectomy via introduction of a dedicated clinical pathway
. J Perioper Pract
. 2020
;30
(6
):156
–62
. 10.
Greilsamer
T
, Orion
F
, Denimal
F
, De Kerviler
B
, Jean
MH
, Dimet
J
, et al. Increasing success in outpatient laparoscopic cholecystectomy by an optimal clinical pathway
. ANZ J Surg
. 2018
;88
(7–8
). 11.
Zhang
M
, Zhou
SY
, Xing
MY
, Xu
J
, Shi
XX
, Zheng
SS
. The application of clinical pathways in laparoscopic cholecystectomy
. Hepatobiliary Pancreat Dis Int
. 2014
;13
(4
):348
–53
. 12.
Manzia
TM
, Quaranta
C
, Filingeri
V
, Toti
L
, Anselmo
A
, Tariciotti
L
, et al. Feasibility and cost effectiveness of ambulatory laparoscopic cholecystectomy. A retrospective cohort study
. Ann Med Surg
. 2020
;55
:56
–61
. 13.
Topal
B
, Peeters
G
, Verbert
A
, Penninckx
F
. Outpatient laparoscopic cholecystectomy: clinical pathway implementation is efficient and cost effective and increases hospital bed capacity
. Surg Endosc
. 2007
;21
(7
):1142
–6
. 14.
Trevino
CM
, Katchko
KM
, Verhaalen
AL
, Bruce
ML
, Webb
TP
. Cost effectiveness of a fast-track protocol for urgent laparoscopic cholecystectomies and appendectomies
. World J Surg
. 2016
;40
(4
):856
–62
. 15.
Vaughan
J
, Gurusamy
KS
, Davidson
BR
. Day-surgery versus overnight stay surgery for laparoscopic cholecystectomy
. Cochrane Database Syst Rev
. 2013
;2013
(7
):Cd006798
. 16.
Xiong
W
, Li
M
, Wang
M
, Zhang
S
, Yang
Q
. The safety of laparoscopic cholecystectomy in the day surgery unit comparing with that in the inpatient unit: a systematic review and meta-analysis
. BioMed Res Int
. 2020
;2020
:1924134
. 17.
Widjaja
SP
, Fischer
H
, Brunner
AR
, Honigmann
P
, Metzger
J
. Acceptance of ambulatory laparoscopic cholecystectomy in Central Switzerland
. World J Surg
. 2017
;41
(11
):2731
–4
. 18.
Janeway
MG
, Sanchez
SE
, Rosen
AK
, Patts
G
, Allee
LC
, Lasser
KE
, et al. Disparities in utilization of ambulatory cholecystectomy: results from three states
. J Surg Res
. 2021
;266
:373
–82
. 19.
Bailey
CR
, Ahuja
M
, Bartholomew
K
, Bew
S
, Forbes
L
, Lipp
A
, et al. Guidelines for day-case surgery 2019: guidelines from the association of anaesthetists and the British association of day surgery
. Anaesthesia
. 2019
;74
(6
):778
–92
. 20.
Strohäker
J
, Wiegand
L
, Beltzer
C
, Königsrainer
A
, Ladurner
R
, Bachmann
R
. Routine postoperative blood tests fail to reliably predict procedure-related complications after laparoscopic cholecystectomy
. Langenbecks Arch Surg
. 2021
;406
(4
):1155
–63
. 21.
Ben-Ishay
O
, Zeltser
M
, Kluger
Y
. Utility of routine blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones
. World J Gastrointest Surg
. 2017
;9
(6
):149
–52
. 22.
Fischer
L
, Kolb
G
, Segendorf
C
, Huber
B
, Watrinet
K
, Horoba
L
, et al. [Which patient needs controls of laboratory values after elective laparoscopic cholecystectomy? Can a score help?]
. Chirurg
. 2021
;92
(4
):369
–73
. 23.
MingJun
H
, Yan
D
, JiPing
L
, HongSheng
M
. Thirty-day unplanned readmission after ambulatory laparoscopic cholecystectomy in western China: a retrospective study
. Cureus
. 2021
;13
(3
):e13932
. 24.
Coelho
JCU
, Dalledone
GO
, Martins Filho
EL
, Ramos
EJB
, Roeder da Costa
MA
, de Loyola E Silva
OOHM
. Feasibility of routine ambulatory laparoscopic cholecystectomy in Brazil
. J Soc Laparoendosc Surg
. 2019
;23
(2
):e2019.00016
. 25.
Salleh
AA
, Affirul
CA
, Hairol
O
, Zamri
Z
, Azlanudin
A
, Hilmi
MA
, et al. Randomized controlled trial comparing daycare and overnight stay laparoscopic cholecystectomy
. Clin Ter
. 2015
;166
(3
):e165
–8
. 26.
Johansson
M
, Thune
A
, Nelvin
L
, Lundell
L
. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy
. Br J Surg
. 2006
;93
(1
):40
–5
. 27.
Keulemans
Y
, Eshuis
J
, de Haes
H
, de Wit
LT
, Gouma
DJ
. Laparoscopic cholecystectomy: day-care versus clinical observation
. Ann Surg
. 1998
;228
(6
):734
–40
. 28.
Hao
XY
, Shen
YF
, Wei
YG
, Liu
F
, Li
HY
, Li
B
. Safety and effectiveness of day-surgery laparoscopic cholecystectomy is still uncertain: meta-analysis of eight randomized controlled trials based on GRADE approach
. Surg Endosc
. 2017
;31
(12
):4950
–63
. 29.
Gurusamy
KS
, Junnarkar
S
, Farouk
M
, Davidson
BR
. Day-case versus overnight stay for laparoscopic cholecystectomy
. Cochrane Database Syst Rev
. 2008
(3
):Cd006798
. 30.
Ryan
JM
, O’Connell
E
, Rogers
AC
, Sorensen
J
, McNamara
DA
. Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy
. HPB Oxf
. 2021
;23
(2
):161
–72
. 31.
Bueno Lledó
J
, Granero Castro
P
, Gomez I Gavara
I
, Ibañez Cirión
JL
, López Andújar
R
, García Granero
E
. Twenty-five years of ambulatory laparoscopic cholecystectomy
. Cir Esp
. 2016
;94
(8
):429
–41
. 32.
Allen
K
, Morris
R
, Lipp
A
. Day procedure survey: self care post discharge at the Norfolk and Norwich University Hospital (NNUH)
. Journal of One Day Surgery S.
; 2015
. Vol. 25
; p. A20
.33.
Wu
Q
, Fu
N
, Chen
W
, Jin
X
, He
L
, Mo
C
, et al. Risk factors for patient selection in ambulatory laparoscopic cholecystectomy: a Single-centre experience
. J Minim Access Surg
. 2022
;18
(2
):302
–7
. 34.
Rao
A
, Polanco
A
, Qiu
S
, Kim
J
, Chin
EH
, Divino
CM
, et al. Safety of outpatient laparoscopic cholecystectomy in the elderly: analysis of 15,248 patients using the NSQIP database
. J Am Coll Surg
. 2013
;217
(6
):1038
–43
. 35.
Cao
J
, Liu
B
, Shi
J
, Meng
X
, Zhang
H
, Pan
Y
, et al. Safety of ambulatory laparoscopic cholecystectomy in the elderly
. ANZ J Surg
. 2021
;91
(4
):597
–602
. 36.
Balciscueta
I
, Barberà
F
, Lorenzo
J
, Martínez
S
, Sebastián
M
, Balciscueta
Z
. Ambulatory laparoscopic cholecystectomy: systematic review and meta-analysis of predictors of failure
. Surgery
. 2021
;170
(2
):373
–82
. 37.
Bazoua
G
, Tilston
MP
. Male gender impact on the outcome of laparoscopic cholecystectomy
. J Soc Laparoendosc Surg
. 2014
;18
(1
):50
–4
. 38.
Sutcliffe
RP
, Hollyman
M
, Hodson
J
, Bonney
G
, Vohra
RS
, Griffiths
EA
, et al. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients
. HPB Oxf
. 2016
;18
(11
):922
–8
. 39.
El-Sharkawy
AM
, Tewari
N
, Vohra
RS
; CholeS Study Group, West Midlands Research Collaborative
. The cholecystectomy as A day case (caad) score: a validated score of preoperative predictors of successful day-case cholecystectomy using the CholeS data set
. World J Surg
. 2019
;43
(8
):1928
–34
. © 2024 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2024
You do not currently have access to this content.
