Clinical Study of Delayed Discharge after Laparoscopic-Cholecystectomy

Lee, Sung Ryol; Shin, Jun Ho

Abstract

PURPOSE
Laparoscopic cholecystectomy (LC) has become the treatment of choice for most gallbladder disease. The aim of this study was to identify the factors related to extended hospital stay following LC.
METHODS
Between March 2005 and December 2007, 819 patients underwent LC at our institution. Based on length of hospital stay (mean postoperative hospital stay was 3.7 days), patients were divided into two groups: group A staying for no more than 4 hospital days (715 patients) and group B staying for more than 4 hospital days (104 patients). The clinicopathologic characteristics, perioperative outcomes and hospital courses were retrospectively compared between the two groups. We also analyzed the causes of delayed discharge after LC.
RESULTS
Group A was younger than group B and there were significant differences between the two groups in terms of gender, comorbidity, ASA score, operation time, clinical symptoms, laboratory findings, and final diagnosis (p<0.05). Delayed discharge was mainly due to refusal of patients or relatives (13 cases), occurrence of perioperative complications (19 cases), severe inflammation of the gallbladder (13 cases) and abdominal discomfort of unknown origin (10 cases). Bile leakage occurred in 1 patient and he had the longest hospital stay.
CONCLUSION
The causes of delayed discharge after LC were varied and were mainly associated with patients themselves. However, several causes were associated with the operative procedure and may be avoided by careful surgical approach.