腹腔镜胆囊切除日间手术在县级医院开展的安全性与成本效益分析

Safety and cost-effectiveness analysis of day surgery of laparoscopic cholecystectomy in county-level hospital

目的:分析腹腔镜胆囊切除日间手术在县级医院开展的安全性及成本效益分析。方法:回顾分析2017年1月1日至2017年6月30日由同一手术团队开展的18例腹腔镜胆囊切除日间手术,对患者术前准备、出院前评估及术后随访情况进行分析。结果:18例日间手术均获成功,入院24 h内出院,无延长出院病例,出院后1周预约复查,均保持随访,无相关并发症发生,住院费用降低,患者满意度100%。结论:采用合适的选择标准行腹腔镜胆囊切除日间手术是安全、可行、有效的,其再住院率低,并发症少,节约成本,提高了患者满意度,同时加快了目前分级诊疗制度的推进。

Objective：To analyze the safety and cost-effectiveness of day surgery of laparoscopic cholecystectomy performed in county-level hospital.Methods：Eighteen consecutive patients who underwent day surgery of laparoscopic cholecystectomy were retrospectively analyzed.All subjects were operated by the same hepato-pancreato-biliary team from Jan.1 st,2017 to Jun.30th,2017.The preoperative preparation,pre-discharge evaluation and postoperative follow-up were analyzed.Results：All 18 day surgeries were completed successfully.The patients were discharged within 24 h without prolonged discharge,and followed up one week later after discharge.No patient showed any complications.The average hospitalization cost was reduced,and the patient satisfaction was 100％.Conclusions：With appropriate selection criteria,day surgery of laparoscopic cholecystectomy is safe,feasible and effective.With lower readmission rate,less complications,smaller cost and higher satisfaction,its development will speed up the current classification system of diagnosis and treatment.