Ambulatory laparoscopic cholecystectomy: Is it safe and cost effective?

BACKGROUND: Laparoscopic cholecystectomy (LC) is the most commonly performed minimal invasive surgery. However, practice of its use as an ambulatory surgery in our hospital settings is uncommon. OBJECTIVE: To evaluate safety and cost effectiveness of LC as an ambulatory day care surgery. STUDY DESIGN: Quasiexperimental. SETTING: Department of surgery, Aga Khan University Hospital, Karachi, Pakistan. MATERIALS AND METHODS: Patients with uncomplicated symptomatic gallstones were selected for Ambulatory LC. They were admitted electively on the same day and operated on in the morning hours and discharged after a check by the surgeon 6–8 hrs later. RESULTS: Of fifty (n = 50) patients selected for ambulatory LC, 92% were discharged successfully after 6–8 hrs observation. No significant perioperative complications were noted. Unplanned admission and readmission rate was 8 and 2%, respectively. Cost saving for the daycare surgery was Rs. 6,200, Rs. 13,300, and Rs.22,800 per patient as compared to in patient general, semiprivate, and private ward package, respectively. CONCLUSION: Practice ambulatory LC is safe and cost-effective in selected patients with uncomplicated symptomatic gallstones.