Preoperative predictive factors of ambulatory laparoscopic cholecystectomy

Abstract

Background:

The aim of our study was to review our experience and to determine preoperative predictive factors for ambulatorization of laparoscopic cholecystectomy (LC).

Methods:

Between January 1999 and June 2002, 305 consecutive LC were performed as outpatient procedures. We performed univariant and multivariant analysis of preoperative clinical, analytical and ultrasonographic variables. The preoperative scoring system developed allowed us to calculate the ambulatorization probability of LC in each individual patient.

Results:

265 patients were strictly ambulatory (86.8%). Thirty-five patients required overnight admission (11.4%), most of them due to social factors, and five patients were admitted. Preoperative factors related to overnight stay or admission were: age over 65 years (p = 0.011), past history of biliary complications (p = 0.001), previous admission due to complicated biliary disease (p = 0.001), previous supramesocholic abdominal surgery (p = 0.011) and ultrasonographic findings of gallbladder thickened wall and/or shrunken gallbladder (p = 0.041). Right classification index of the predictive system was 87.5% reaching a sensibility of 87.8% and specificity of 56.6%.

Conclusions:

Outpatient LC is safe and feasible. Age, previous biliary history and ultrasonographic findings are independent preoperative factors influencing ambulatorization rate.