Title : Outcomes of short-stay laparoscopic cholecystectomy: A study of safety and efficiency at trat hospital, Thailand
Abstract:
BACKGROUND: Laparoscopic cholecystectomy (LC) is the standard procedure for treating symptomatic gallstones. The development of an outpatient treatment approach and a short stay model could help reduce hospital stay duration and costs while maintaining safety and efficiency comparable to inpatient treatment. OBJECTIVES: To summarize the outcomes of LC in patients with symptomatic gallstones who underwent treatment at Trat Hospital, and to identify factors affecting the success of Short-Stay Laparoscopic Cholecystectomy.
METHODS: This retrospective study involved a review of medical records of symptomatic gallstone patients who underwent elective LC at Trat Hospital between October 1, 2021, and September 30, 2024. Descriptive statistics, Chi-square, Fisher’s exact test, independent t-test, and Logistic regression were used for analysis.
RESULTS: A total of 150 symptomatic gallstone patients who underwent LC were included, with 75 patients in the Short-Stay group and 75 patients in the Inpatient group. Most patients were female (69.3%), with an average age of 51 years. Obesity (BMI ≥ 25 kg/m²) was present in 60% of the patients, and the majority had ASA class 2 (80.7%). The most common comorbidities were hypertension (32.7%), dyslipidemia (24%), and diabetes (17.0%). Safety outcomes and surgical complications were similar between the groups, with no readmissions. Efficiency outcomes differed between the two groups, including surgical time (53 minutes vs. 92 minutes; p<0.001), blood loss (9 ml vs. 25 ml; p<0.001), hospital stay duration (1 day vs. 3 days; p<0.001), and treatment costs (15,138 THB vs. 28,451 THB; p<0.001). Logistic regression analysis revealed that for the Short-Stay group, each additional minute of surgery reduced the likelihood of same-day discharge by 6.7% (OR 0.933; 95% CI, 0.878-0.992; p = 0.027). Surgery performed after 3:00 PM significantly reduced the chances of same-day discharge (OR 0.001; 95% CI, 0.000-0.031; p < 0.001). A history of ERCP was associated with a reduced chance of same-day discharge, though this was not statistically significant (p = 0.426).
CONCLUSIONS: Short-Stay Laparoscopic Cholecystectomy is as safe as inpatient surgery, reduces hospital stay, and lowers hospital costs. Factors affecting successful recovery and same-day discharge include shorter surgical time and performing surgery before 3:00 PM.
KEYWORDS: Symptomatic Gallstone, Laparoscopic Cholecystectomy, Treatment Outcomes, Short-Stay Laparoscopic Cholecystectomy, Inpatient Laparoscopic Cholecystectomy
