Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Fashun ^1,2 , ZHONG Kai ^1,2 , Mureaihemaitijiang?Mutalifu ^1,2 , ZHENG Xiaojie ³ , JIANG Tiemin ^1,2 , RAN Bo ^1,2 , GUO Qiang ^1,2 , ZHANG Ruiqing ^1,2 , SHAO Yingmei ^1,2 ,  Tuerganaili? Aji ^1,2

1. Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;
2. Xinjiang Uygur Autonomous Region Hydatid and Hepatobiliary Disease Clinical Medicine Research Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;
3. Department of Discipline Construction, Teaching and Research Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding?author：

Tuerganaili? Aji, Email: tuergan78@sina.com

Keywords：

gallbladder disease; ambulatory surgery; laparoscope; cholecystectomy; curative effect

DOI：

10.7507/1007-9424.202010003

Video：

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Objective To evaluate and analyze the clinical effect of ambulatory surgery applied to laparoscopic cholecystectomy (LC).Methods The patients who underwent LC in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to February 2019 were collected, then were assigned to ambulatory surgery applied to LC group (ALC group) and conventional LC group (CLC group) according to the admission process mode. The patients in the ALC group received LC in the ambulatory ward and the patients in the CLC group received LC in the conventional ward. The preoperative waiting time, postoperative gastrointestinal recovery time, postoperative 6 h pain score, total hospitalization time, total hospitalization cost, patient satisfaction, and postoperative complications were compared between the two groups.Results A total of 433 patients underwent LC were included in this study, including 176 patients in the ALC group and 257 patients in the CLC group. There were no significant differences in the age, gender, type of gallbladder diseases, etc. between the two groups (P>0.05) except body mass index (P<0.05). There was no perioperative death in the two groups. One patient converted to laparotomy in the CLC group. Compared with the CLC group, the preoperative waiting time, postoperative gastrointestinal recovery time, and the total hospitalization time were shorter, the postoperative pain score was lower, the total hospitalization cost was less, and the satisfaction rate of patients was higher in the ALC group (P<0.05). There was 1 case of incision infection and 1 case of ascites in the operation area in the ALC group and CLC group, 1 case of fever in the ALC group and 3 cases of fever in the CLC group, respectively. There was no difference in the overall incidence of complications between the two groups (P>0.05). During the follow-up of 6 to 26 months, there was no readmission in both groups.Conclusion Patients who undergone LC based on ambulatory surgery mode recover quickly, and hospitalization cost is less, satisfaction rate is higher.

Citation： LU Fashun, ZHONG Kai, Mureaihemaitijiang?Mutalifu, ZHENG Xiaojie, JIANG Tiemin, RAN Bo, GUO Qiang, ZHANG Ruiqing, SHAO Yingmei, Tuerganaili? Aji. Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 856-860. doi: 10.7507/1007-9424.202010003 Copy

1.	馬建偉, 楊曉軍, 張芙莉, 等. 基于加速康復外科理念的無痛腹腔鏡膽囊切除術的臨床研究. 中國普外基礎與臨床雜志, 2016, 23(5): 581-585.
2.	Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg, 1990, 160(5): 485-487.
3.	Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
4.	馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復(ERAS)規范. 中國胸心血管外科臨床雜志, 2016, 23(2): 104-106.
5.	中華醫學會外科學分會中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018 版). 中國實用外科雜志, 2018, 38(1): 1-20.
6.	Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
7.	?oltés V, Gavurová B. The possibilities of day surgery system development within the health policy in Slovakia. Health Econ Rev, 2014, 4(1): 35.
8.	俞衛鋒. 淺談日間手術模式. 中華麻醉學雜志, 2016, 36(5): 513-514.
9.	姜華, 李云濤, 劉雁軍, 等. 加速康復外科在擇期結直腸手術中的評估. 中國普外基礎與臨床雜志, 2016, 23(8): 1011-1017.
10.	徐成, 吐爾干艾力·阿吉, 郭強, 等. 加速康復外科在日間病房內鏡逆行胰膽管造影治療膽總管結石中的應用. 中華普通外科學文獻(電子版), 2019, 13(3): 213-218.
11.	Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
12.	譚黃業, 樊獻軍, 張力峰, 等. 快速康復外科理念指導下的腹腔鏡膽囊切除術135例. 解放軍醫藥雜志, 2011, 23(3): 30-32.
13.	Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
14.	劉洋, 馬洪升, 李志超, 等. 5 520 例日間手術的安全和質量評價. 中國普外基礎與臨床雜志, 2015, 22(12): 1477-1481.
15.	李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的Meta分析. 中華普通外科學文獻(電子版), 2018, 12(6): 444-450.
16.	郭強, 吐爾干艾力·阿吉, 鐘鍇, 等. 加速康復外科理念在日間腹腔鏡闌尾切除術中的應用效果研究. 中華全科醫師雜志, 2019, 18(8): 760-764.
17.	Subirana Magdaleno H, Caro Tarragó A, Olona Casas C, et al. Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial. Cir Esp, 2018, 96(2): 88-95.
18.	Coelho JCU, Dalledone GO, Martins Filho EL, et al. Feasibility of routine ambulatory laparoscopic cholecystectomy in Brazil. JSLS, 2019, 23(2): e2019.00016.

1. 馬建偉, 楊曉軍, 張芙莉, 等. 基于加速康復外科理念的無痛腹腔鏡膽囊切除術的臨床研究. 中國普外基礎與臨床雜志, 2016, 23(5): 581-585.
2. Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg, 1990, 160(5): 485-487.
3. Mayo I, Lizarondo L, Stokan M. Experiences of adult patients in discharge and recovery from day surgery: a qualitative systematic review protocol. JBI Database System Rev Implement Rep, 2019, 17(2): 164-169.
4. 馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復(ERAS)規范. 中國胸心血管外科臨床雜志, 2016, 23(2): 104-106.
5. 中華醫學會外科學分會中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018 版). 中國實用外科雜志, 2018, 38(1): 1-20.
6. Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
7. ?oltés V, Gavurová B. The possibilities of day surgery system development within the health policy in Slovakia. Health Econ Rev, 2014, 4(1): 35.
8. 俞衛鋒. 淺談日間手術模式. 中華麻醉學雜志, 2016, 36(5): 513-514.
9. 姜華, 李云濤, 劉雁軍, 等. 加速康復外科在擇期結直腸手術中的評估. 中國普外基礎與臨床雜志, 2016, 23(8): 1011-1017.
10. 徐成, 吐爾干艾力·阿吉, 郭強, 等. 加速康復外科在日間病房內鏡逆行胰膽管造影治療膽總管結石中的應用. 中華普通外科學文獻(電子版), 2019, 13(3): 213-218.
11. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
12. 譚黃業, 樊獻軍, 張力峰, 等. 快速康復外科理念指導下的腹腔鏡膽囊切除術135例. 解放軍醫藥雜志, 2011, 23(3): 30-32.
13. Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
14. 劉洋, 馬洪升, 李志超, 等. 5 520 例日間手術的安全和質量評價. 中國普外基礎與臨床雜志, 2015, 22(12): 1477-1481.
15. 李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的Meta分析. 中華普通外科學文獻(電子版), 2018, 12(6): 444-450.
16. 郭強, 吐爾干艾力·阿吉, 鐘鍇, 等. 加速康復外科理念在日間腹腔鏡闌尾切除術中的應用效果研究. 中華全科醫師雜志, 2019, 18(8): 760-764.
17. Subirana Magdaleno H, Caro Tarragó A, Olona Casas C, et al. Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial. Cir Esp, 2018, 96(2): 88-95.
18. Coelho JCU, Dalledone GO, Martins Filho EL, et al. Feasibility of routine ambulatory laparoscopic cholecystectomy in Brazil. JSLS, 2019, 23(2): e2019.00016.

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Curative effect analysis of ambulatory pattern in laparoscopic cholecystectomy

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