Evaluation on social and economic benefits of day surgery laparoscopic cholecystectomy in 1240 patients

Objective　To evaluate the social and economic benefits of day surgery laparoscopic cholecystectomy(LC/DS).Methods　Clinical datum of 1240 patients undergoing LC/DS and 476 cases undergoing routine LC at General Hospital of Chinese People′s Liberation Army from November 2009 to December 2010 were retrospectively studied.Rate of conversion to open procedure，complications，length of stay in hospital，medical costs and patient satisfaction rate were compared between patients received LC/DS and routine LC.Data was analyzed using SPSS 16.0，differences between two groups were assessed using t tests for continuous variables and chi-square tests for categorical variables.Results　The average age in patients of LC/DS group was 52.3 years.1236 cases were preformed by LC and conversion to laparotomy occurred in 4 patients，the conversion rate was 0.16% as two cases of gallbladder carcinoma were excluded.Six (0.48%) complications developed.The severe complications of bile duct injury and stomach or bowel injury did not happen in LC/DS group.The average age in patients of routine LC group was 51.9 years.Eight (1.68%) patients required conversion to the open technique.Eleven (2.31%) complications including one bile duct injury and one colon injury developed in routine LC group.None of the patients died as a result of LC in both LC/DS and routine LC groups.Rate of conversion to open operation was 0.16%and 1.68%(χ2＝11.2086，P＝0.0008) in LC/DS and routine LC groups respectively，complication was 6 and 11 cases (χ2＝11.706，P＝0.001)，length of stay in hospital was (1.6±0.6)and(4.8±0.9)days (t＝85.244，P＝0.0000)，medical costs was (8028±338)and(9016±266)Yuan (RMB)(t＝57.32，P＝0.0000)，patient satisfaction rate was 95.4% and 95.7% respectively (χ2＝0.125，P＝0.723).Conclusions　Implementation of the day surgery laparoscopic cholecystectomy resulted in a significant reduction in medical resource use，including a decreased length of stay and total cost of care.This procedure is worth promoting in China.