日间手术诊疗模式的探索附59例腹腔镜胆囊切除术病例分析

Day-case laparoscopic cholecystectomy： analysis of 59 consecutive patients

目的总结开展的日间腹腔镜胆囊切除术结果，探讨在我国行日间腹腔镜胆囊切除术的可行性。方法回顾性分析2013年1月-2015年1月在苏州大学附属第一医院由同一名手术医师完成的腹腔镜胆囊切除术59例，每例患者均于当日上午手术，术后24h内出院。术后3天内每日电话随访，术后第7—9天拆线，术后第7天门诊复查。结果59例患者手术均顺利，无一例中转开腹，手术时间平均25min，术后6h即恢复半流质饮食，术后伤口疼痛9例，伤口少量渗血5例，呕吐16例，给予常规对症处理后缓解。59例患者均于术后24h出院，术后3天内电话随访54例无异常，3例伤口稍疼痛，2例仍有恶心感，术后第7天门诊复查无异常，伤I：1无感染。59例患者住院花费平均8240元。结论腹腔镜胆囊切除术作为微创手术的代表术式之一，在我国行日间手术，于术后24h内出院是安全可行的，可显著减少住院时间和花费，值得推广。

Objective To evaluate the feasibility and outcome of laparoscopic choleeysteetomy as a overnight procedure in China. Methods The data of 59 consecutive patients who had undergone outpatient laparoscopic cholecystectomy between January 2013 and January 2015. All the patients were operated in the morning hours and discharged during 24 hours after operation. They were contacted by telephone 3 days subsequent to surgery and were seen in the outpatient unit 7 days after. Results Fifty-nine laparoscopic cholecystectomies were performed. No Conversion to open surgery case. The average operation time was 25 minutes, and restore semi-liquid diet 6 hours after the operation All the 59 patients were discharged during 24 hours after operations. None of the patients had an emergency readmission. None of the patients had complications 7 days after discharged. The average payment was 8 240 yuan. Conclusion These results suggest that laparoscopic cholecystectomy can be routinely performed as a overnight procedure.