Five-year experience of outpatient laparoscopic cholecystectomy in Hong Kong

Laparoscopic cholecystectomy (LC) is the standard procedure for the management of symptomatic gallstone disease. There are many studies that have evaluated LC in an outpatient setting and the results are promising. The aim of the present study was to evaluate our experience in outpatient laparoscopic cholecystectomy during a five-year period. We recruited 135 consecutive patients with symptomatic gall bladder disease to undergo outpatient LC from February 2000 to May 2004. The overall successful outpatient rate was 93% and it gradually increased from 72.7% to 100% during the five-year period. The overnight admission and conversion rate decreased in concordance with the increase in the outpatient LC rate. No major complications were encountered and the pain control was good. Opiate-free anaesthetic protocol, involvement of an experienced anaesthesiologist and surgeon, good preoperative counselling and a well-equipped day surgery centre are the prerequisites for the success of this new procedure. Nevertheless, one should be well prepared before the commencement of the program and potential disastrous complications cannot be overlooked.