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.