Intent at Day Case Laparoscopic Cholecystectomy in Owerri, Nigeria: Initial Experiences

Abstract

Background and Objective: Laparoscopic cholecystectomy has been the default operation for cholelithiasis at Federal Medical Centre, Owerri for the past 2 years and the outcomes have been good. The duration of post operative stay has been decreasing. We therefore initiated a preliminary 2.year prospective study in May 2010 to determine the feasibility of carrying out day case laparoscopic cholecystectomy in our hospital.

Materials and Methods: Patients undergoing laparoscopic cholecystectomy were included in the study if they satisfied the following criteria: Age < 65 years, body mass index < 35 kg/m2, American Society of Anaesthesiology
physical status class I and II, patient residence within 20 km radius of the hospital, patient acceptance of the procedure and absence of previous complicated upper abdominal surgery.
Results: Twelve patients (10 females, 2 males) were worked up with the intent of achieving same.day discharge of the patients. Five of the patients (41.7%) were discharged on the day of operation. The reasons for overnight stay included inadequate pain control, insertion of drain and patient wishes. There was no conversion to open surgery, no major complications and no case of readmission to the hospital.
Conclusions: Day case laparoscopic cholecystectomy in our environment could be safely promoted but will depend
on improved facilities and patient enlightenment.

Keywords: Day case, laparoscopic cholecystectomy, cholelithiasis