Evaluation of Patient Safety and Satisfaction in a Program of Ambulatory Laparoscopic Cholecystectomy Program With Expanded Criteria

Angela Sala-Hernández, Pablo Granero Castro, Eva Montalvá Orón, Javier Maupoey Ibáñez, Rafael García-Domínguez, José Bueno Lledó, Jose Luís Ibáñez Cirión, Rafael López Andújar.

Cirugía Española (English Edition), Volume 97, Issue 1, janvier 2019.

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 demonstrate 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.