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Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil.
JSLS 2019 Apr-Jun; 23(2)JSLS

Abstract

Background and Objectives

In several developed countries, most laparoscopic cholecystectomies (LCs) are performed as an ambulatory operation (ALC) with a high rate of success. In Latin America, the experience with this procedure is still limited. Our objective is to evaluate the feasibility to implement ALC in a Brazilian teaching hospital.

Methods

Data obtained from electronic medical records and study protocols of all patients who underwent an LC between January 2011 and March 2018 were evaluated. All patients with chronic or acute cholecystitis were initially considered for an ALC.

Results

Of a total of 1645 patients who underwent LC, 1577 (95.9%) were discharged on the same day of the operation. The main reasons for hospital admission after ALC were patient refusal to be discharged (n = 23; 1.4%), nausea and vomiting (n = 15; 0.9%), and complicated acute cholecystitis. No patient was excluded from consideration for ALC based only on age, history of previous upper abdominal operation, and presence of comorbidity. Patient age ranged from 12 to 100 years, with a mean of 50.23 ± 15.35 years. Intraoperative and postoperative complication rates were 0.4% and 5.5%, respectively. Most perioperative complications were because of technical surgical difficulties and complications common to most abdominal operations (surgical site, pulmonary, urinary, and venous complications). Thirteen (0.8%) patients were readmitted to the hospital because of abdominal pain and fever (n = 4), pneumonia (n = 3), deep venous thrombosis (n = 3), or urinary retention (n = 3).

Conclusions

ALC may be performed in Brazil with low rates of morbidity, mortality, and hospital readmission. Its implementation should be stimulated in Latin America.

Authors+Show Affiliations

Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.Department of Surgery. Hospital Nossa Senhora das Graças and Hospital de Clinicas. Federal University of Parana, Curitiba, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31097907

Citation

Coelho, Júlio Cezar Uili, et al. "Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 23, no. 2, 2019.
Coelho JCU, Dalledone GO, Martins Filho EL, et al. Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil. JSLS. 2019;23(2).
Coelho, J. C. U., Dalledone, G. O., Martins Filho, E. L., Ramos, E. J. B., Roeder da Costa, M. A., & de Loyola E Silva, O. O. H. M. (2019). Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 23(2), doi:10.4293/JSLS.2019.00016.
Coelho JCU, et al. Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil. JSLS. 2019;23(2) PubMed PMID: 31097907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of Routine Ambulatory Laparoscopic Cholecystectomy in Brazil. AU - Coelho,Júlio Cezar Uili, AU - Dalledone,Giuliano Ohde, AU - Martins Filho,Eduardo Lopes, AU - Ramos,Eduardo José Brommelstroet, AU - Roeder da Costa,Marco Aurélio, AU - de Loyola E Silva,Omar O H M, PY - 2019/5/18/entrez PY - 2019/5/18/pubmed PY - 2019/8/8/medline KW - Ambulatory surgery KW - Cholelithiasis KW - Laparoscopic cholecystectomy JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 23 IS - 2 N2 - Background and Objectives: In several developed countries, most laparoscopic cholecystectomies (LCs) are performed as an ambulatory operation (ALC) with a high rate of success. In Latin America, the experience with this procedure is still limited. Our objective is to evaluate the feasibility to implement ALC in a Brazilian teaching hospital. Methods: Data obtained from electronic medical records and study protocols of all patients who underwent an LC between January 2011 and March 2018 were evaluated. All patients with chronic or acute cholecystitis were initially considered for an ALC. Results: Of a total of 1645 patients who underwent LC, 1577 (95.9%) were discharged on the same day of the operation. The main reasons for hospital admission after ALC were patient refusal to be discharged (n = 23; 1.4%), nausea and vomiting (n = 15; 0.9%), and complicated acute cholecystitis. No patient was excluded from consideration for ALC based only on age, history of previous upper abdominal operation, and presence of comorbidity. Patient age ranged from 12 to 100 years, with a mean of 50.23 ± 15.35 years. Intraoperative and postoperative complication rates were 0.4% and 5.5%, respectively. Most perioperative complications were because of technical surgical difficulties and complications common to most abdominal operations (surgical site, pulmonary, urinary, and venous complications). Thirteen (0.8%) patients were readmitted to the hospital because of abdominal pain and fever (n = 4), pneumonia (n = 3), deep venous thrombosis (n = 3), or urinary retention (n = 3). Conclusions: ALC may be performed in Brazil with low rates of morbidity, mortality, and hospital readmission. Its implementation should be stimulated in Latin America. SN - 1938-3797 UR - https://www.unboundmedicine.com/medline/citation/31097907/Feasibility_of_Routine_Ambulatory_Laparoscopic_Cholecystectomy_in_Brazil L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31097907/ DB - PRIME DP - Unbound Medicine ER -