[Comparative study of ambulatory laparoscopic cholecystectomy versus management of laparoscopic cholecystectomy with conventional hospital stay]. / Colecistectomía laparoscópica ambulatoria versus con ingreso: estudio de efectividad y calidad.

ABSTRACT

INTRODUCTION: To analyse the effectiveness and quality of ambulatory laparoscopic cholecystectomy (CLCMA) versus management of laparoscopic cholecystectomy with conventional hospital stay (CLEST). MATERIAL AND METHODS: A retrospective study was conducted on all patients ASA I-II, who had a laparoscopic cholecystectomy (LC) over a period of 6 years. The patients were divided into 2 groups group CLCMA (n = 141 patients) and group CLEST (n = 286 patients). The effectiveness was analysed by evaluating morbidity, further surgery, re-admission and hospital stay. The quality analysis was performed using CLCMA group satisfaction surveys and subsequent assessment by indicators of satisfaction. RESULTS: There was no significant differences between groups (CLEST vs. CLCMA) in morbidity (5.24 vs 4.26), further surgery (2.45 vs. 1.42) or re-admissions (1.40 vs. 3.55). There was no postoperative mortality. In the CLCMA group 82% of patients were discharged on the same day of surgery, with a mean stay of 1.16 days, while in the CLEST group the mean hospital stay was 2.94 days (P=.003).The overall satisfaction rate was 82%, and the level of satisfaction of care received was 81%, both above the previously set standard. CONCLUSIONS: CLCMA is just as effective and safe as hospital based CLEST, with a good level of perceived quality.