Total quality management in laparoscopic cholecystectomy. Quality of care and quality perception in ambulatory laparoscopic cholecystectomy.

OBJECTIVE: Analysis of acceptance and perception of quality in patients undergoing ambulatory laparoscopic cholecystectomy. PATIENTS: 84 consecutive patients undergoing elective laparoscopic cholecystectomy within SVS (Servei Valencia de Salut) through a special plan for waiting lists. METHODS: A prospective analysis of related variables with quality perception evaluated by a specialized nurse with no interaction with the surgical team. RESULTS: Ambulatory acceptance, 80 percent; return to work or daily activities at 72 hours after surgery, 40 percent. Extra need of medical attention was as follows: emergency general practitioner 2.7 percent, emergency room attention in 1.3 percent, extra telephone interview with the surgeon 6.0 percent. Global estimation of the procedure was very good or good by 94.7 percent. CONCLUSIONS: High acceptance rate, high quality perception. Up to 20 percent of patients would change from ambulatory to traditional surgery, possibly due to cultural factors.