Laparoscopie laser cholecystectomy has been performed clinically in the United States since 1988. After refinement of the technique, the procedure was offered on an outpatient basis. Eighty-three patients underwent laparoscopic laser cholecystectomy during the study period. Thirty-seven (45%) had the procedure as an outpatient. Younger patients were more suited for the outpatient procedure and those without previous surgery were more likely to have the procedure done as an outpatient. Weight, operating time, and gallbladder pathology were similar, although patients with acute inflammation of the gallbladder were more likely to require hospitalization. The primary reason for patient admission was patient preference.
C ost containment has become a major issue in Ameri- can medicine, forcing surgeons to search for ways to perform major surgery on an outpatient basis. We have previously reported the removal of the gallbladder via laparoscopy utilizing laser technology [1][2][3]. With perfection of this technique, we have been able to perform laparoscopic laser cholecystectomy on an outpatient basis in selected patients. This report details our outpatient experience with this operation.
PATIENTS AND METHODS
After 50 inpatient cases of laparoscopic laser cholecystectomy (LLC) had been performed by the authors, LLC was offered as an outpatient procedure to all patients who presented to our office with gallstone disease during the 6-month period between May and October 1989. All patients with documented gallbladder pathology were considered candidates for LLC. If it were decided intraoperatively that LLC could not be performed, the procedure was converted to standard cholecystectomy (so).
Patients were prepared for surgery with routine preoperative laboratory studies (complete blood cell count,