Discharge within 24 hours of elective cholecystectomy. The first 100 patients
G. Moss
Discharge with 24 hours of elective cholecystectomy has proved to be an
attainable goal for the vast majority of patients, without increasing risk.
The clinical courses of the first 100 subjects (of 109 consecutive
patients) to reach this goal were examined critically. Preservation of
gastrointestinal function and immediate full enteral nutrition were major
steps toward reduction of hospital dependency. Pain and the need for
narcotics were reduced by careful patient instruction and wound
infiltration with a long-acting local anesthetic. Preoperative
hospitalization was eliminated by outpatient testing and admission for 29
subjects, who were admitted the day of surgery. This group's entire stay
was only one day. Patients and family found the total regimen acceptable by
independent review. Significant cost savings were realized as a fringe
benefit.
