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A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy.

机译：门诊和住院腹腔镜胆囊切除术的荟萃分析。

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BACKGROUND: Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients. METHODS: A systematic review of Cochrane, Embase, and Medline using the keywords "ambulatory," "laparoscopic," and "cholecystectomy" was performed. Postoperative complications leading to admissions and readmissions were compared between day care and inpatient laparoscopic cholecystectomy groups. Postoperative quality of life, patient satisfaction, and cost effectiveness also were analyzed. RESULTS: The search process identified seven clinical trials suitable for meta-analysis. These trials, consisting of 598 patients, compared day care and inpatient procedures. The unplanned admission rate in the ambulatory group was comparable with the prolonged hospitalization of inpatients (odds ratio [OR], 1.979; 95% confidence interval [CI], 0.846-4.628). There was no significant difference between the readmission rates of the two groups (OR, 0.964; 95% CI, 0.318-2.922). The quality-of-life indicators were similar for the ambulatory and overnight-stay patients (p = 0.195). The cost effectiveness was better for the day care procedures because of the shorter mean hospital stay. CONCLUSION: Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction.
机译：背景：腹腔镜胆囊切除术越来越多地用于非卧床手术。这项研究旨在检查其对精心挑选的患者的有效性。方法：使用关键词“门诊”，“腹腔镜”和“胆囊切除术”对Cochrane，Embase和Medline进行了系统评价。比较了日托和住院腹腔镜胆囊切除术组之间导致入院和再入院的术后并发症。还分析了术后生活质量，患者满意度和成本效益。结果：检索过程确定了七项适合荟萃分析的临床试验。这些试验由598名患者组成，比较了日托和住院程序。非卧床组的计划外入院率与住院患者的长期住院治疗相当（几率[OR]为1.979; 95％置信区间[CI]为0.846-4.628）。两组的再入院率之间无显着差异（OR，0.964; 95％CI，0.318-2.922）。卧床和过夜患者的生活质量指标相似（p = 0.195）。由于平均住院时间较短，因此日间护理程序的成本效益更好。结论：可以对选定的患者安全地进行门诊腹腔镜胆囊切除术，从而降低了成本并提高了患者满意度。

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