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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Day Care vs Overnight Stay after Laparoscopic Cholecystectomy even with Co-morbidity and a Possible Second Surgery: A Patient?s Choice
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Day Care vs Overnight Stay after Laparoscopic Cholecystectomy even with Co-morbidity and a Possible Second Surgery: A Patient?s Choice

机译：腹腔镜胆囊切除术后即使有合并症和可能的第二次手术的日托与过夜比较：患者的选择

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Introduction: Laparoscopic Cholecystectomy (LC) has become the gold standard for symptomatic gall stone disease. It is being practiced as a day care procedure in healthy individuals in American Society of Anaesthesialogists (ASA) grade I and II. It is not yet established in presence of co-morbidity and when a second surgery is added. In most of the study, patient?s choice and the psycho-social factors were not considered in deciding the day care procedure. Aim: To find the safety of LC and a second surgery as day care in presence of compensated co-morbidity. To study the choice of the patient whether to stay in hospital or go home after declaring them fit for day care. Materials and Methods: All the patients of symptomatic cholelithiasis with co-morbidity and associations were evaluated and made uncompromising for elective surgery. All the LC were done at 8mmHg CO2 peumo-peritoneal pressure using harmonic scalpel as the energy source for dissection of gall bladder from the liver bed. Cases with conversion and placement of drain were excluded. Results: A total of 1029 out of 1042 patients was included from Jan 2005 to Jan 2015. The age range was 38 to 91years (mean 44.65, SD 14.15). There were 634 females and 395 males. A total of 121(11.7%) of them had co-morbidity and associations. A total of 72(7%) had undergone a second surgery. Only 0.8% had real day care. A total of 95.7% had overnight stay even after fulfilling all the criteria. Only 0.2% needed re-admission in 30 days and one required intervention. Conclusion: Patients like to stay over night in the hospital even if found fit for day care after LC. Overnight stay makes them happy, psycho-socially confident in developing nation and best suited for all patients including co-morbidity.
机译：简介：腹腔镜胆囊切除术（LC）已成为有症状胆结石疾病的金标准。在美国麻醉医师协会（ASA）的I级和II级健康人士中，它被当作日间护理程序进行实践。在合并症的情况下以及增加第二次手术时尚未确定。在大多数研究中，在决定日托程序时并未考虑患者的选择和心理社会因素。目的：在存在合并症的情况下，寻找LC和第二次手术作为日托的安全性。研究患者在宣布他们适合日间护理之后是留在医院还是回家的选择。材料与方法：对所有合并症和相关性有症状胆石症的患者进行评估，并使其毫不妥协地进行择期手术。所有的LC均在8mmHg CO2气腹膜压力下进行，使用谐波解剖刀作为从肝床解剖胆囊的能源。排除了转换和排水的情况。结果：2005年1月至2015年1月，共纳入1042例患者中的1029例。年龄范围为38至91岁（平均44.65，SD 14.15）。有634名女性和395名男性。共有121（11.7％）人患有合并症和关联。共有72（7％）人接受了第二次手术。只有0.8％的人拥有真正的日托服务。即使达到所有标准，仍然有95.7％的人过夜。在30天内，仅0.2％的患者需要重新入院，而其中一项需要干预。结论：即使LC后适合进行日间护理，患者也喜欢在医院过夜。过夜可以使他们在发展中国家感到开心，在社会心理上充满信心，并且最适合包括合并症在内的所有患者。

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