Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit? A. Martínez Vieira, F. Docobo Durántez, J. Mena Robles. Abstract. MOORE, John Henry et al. Ambulatory laparoscopic cholecystectomy: a cost-efficient model of laparoscopic surgery. rev. colomb. cir. [online]. Download Citation on ResearchGate | Colecistectomía laparoscópica ambulatoria | SUMMARY Objective: We present our experience in lap- aroscopic .
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To carry out this prevention, measures such as an exquisite and refined surgical technique to avoid, along with the appropriate analgesic procedures, the appearance of uncontrollable postoperative pain 12 are important, as is a rational use of lapariscopica 13 with a gradual establishment of oral feeding, which should favor early tolerance to food. A prophylactic antibiotic, cefazoline, was administered, and a dressing was applied to the lower limbs of patients with distal vein problems or obesity.
Lapzroscopica term DSU combines processes complementary to surgery performed using coleciwtectomia type of anesthesia that require less intensive postoperative care and are of short duration; therefore patients do not need to stay in the hospital and can be discharged a few hours after the procedure 1.
The only efficient way to prevent these hospital stays is comprehensive information and patient individualization. To evaluate the latter point it is necessary to focus on morbidity markers and quality as perceived by patients 8.
Colecistectomía laparoscópica y cirugía ambulatoria
The histopathological study of the excised gallbladder, whose results were available approximately twenty days after the procedure, reported: The level of complexity of procedures that can be carried out in a DSU is increasing. Factors of clinical significance which determined discharge after 24 hours included: The importance of these studies is relative when compared to downpouring experience pointing that laparoscopy provides a far more benign immediate postoperative time.
Ann Surg ; Dig Liver Dis ; 35 Supl. However, in the Spanish health-care system, which is in need of public beds in most regions, reductions in the hospitalization stay are also important besides savings, so that beds may be put to good use for other patients, which may be achieved via MOS programs including well trained teams in outpatient LC for feasible cases.
Quality of life GIQLI and laparoscopic cholecystectomy usefulness in patients with gallbladder dysfunction or chronic non-lithiasic biliary pain chronic acalculous cholecystitis. Regarding the sex variable, a larger percentage of females, as opposed to males, required hospitalization. Lau H, Brooks DC.
We are entering into what is known as a SSS, which may carry out surgical procedures with hospital stays between one and three days using hospital resources for the least time possible 5although with greater financial cost when compared to a DSU. Thus, not only has laparoscopy advanced in itself, but traditional techniques have also benefited from greater rigor in outcome studies, and healthy competition has shown up regarding “lesser invasion” with increasingly small incisions, and shorter stays and postoperative periods, all of which represents great value for patients.
Indeed, the linking of technologic development circumstances to the will of a number of surgeons to offer less damaging surgery led to the notion of colecitsectomia aggressive surgery”, in which laparoscopic surgery is paradigmatic. Whereas Vieira et al. Analyses of these data showed statistically significant differences in the following variables: Criteria necessary for inclusion in this program of outpatient laparoscopic cholecystectomy included: Laparoscopic cholecystectomy in the treatment of biliary lithiasis: Regarding other surgical procedures habitually included in MOS, LC has the laparoscopiac characteristic of being a technique requiring general anesthesia for an approach of the peritoneal cavity.
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Laparoscopic cholecystectomy in the treatment of biliary lithiasis: Br J Surg ; Laparoscopic cholecystectomy was carried out in all cases following the European technique. Cir Esp ; The same goes for private surgery, but regarding public health-care, a universal, free-of-charge kaparoscopica such as the Spanish one is mainly concerned in hospital stay reduction in addition to reduced costs per procedure, in an attempt to free hospital beds for other procedures and send patients home upon surgery completion.
In laparodcopica groups of patients, we analyzed: One of the most commonly used markers is the rate of events and complications arising during the postoperative period 9.
The accounting peculiarities of the Spanish health-care system makes it very difficult to quantify presumed savings versus inpatient surgery, since the cost needed to set up a home care system infrastructure and that of readmissions should have to be subtracted from reduced costs per bed and day. A prevention of such incidents is the best way to avoid hospital stays.
Patients’ experiences of laparoscopic cholecistectomy in day surgery. Rev Esp Enferm Dig ; 96 7: All of them satisfied the following criteria: If these conditions are theoretically present in DSU as well as in SSS units, which factors will determine hospital stay and what makes a difference between both types of programs?
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Contemporary outcomes of ambulatory laparoscopic cholecistectomy in a major teaching hospital. Mean discharge time was 10 hours after the procedure. Laparoscopic cholecystectomy has been improved in such a way that, used in the treatment of non-complicated biliary lithiasis, it has become a part of the service offered by the SSS units and, nowadays, by the DSUs 2,3. Anyway, patients preoperatively labeled as having alithiasic cholecystopathies are overall excellent candidates to outpatient LC, at least regarding a lower likeliness of complicated surgical procedures.
An experience that is not uncommon in daily practice involves patients who are admitted with acute pancreatitis in whom no lithiasic condition is seen, and who are therefore referred to the Gastroenterology Unit for an etiologic study.
Lau H, Brooks DC. World J Surg ; 26 9: