Colecistectomia laparoscópica em regime ambulatorial

The arrival of cholecystectomy by minilaparotomy provided reduction of the hospitalar stay and the discharge on the same day began to be considered and applied with success to some patients. However, it was with the laparoscopic approach that the ambulatory surgery received strong stimulation. The feasibility of cholecystectomy for calculous chronic cholecystitis under laparoscopy in the outpatient ambulatory setting was evaluated in a prospective study. During the period between January 1994 to January 1997,120 patients were operated. Forty-two were male (35%) and 78 female (65%), aging from 16 to 60 at an average of 38. The patients were selected under the following criteria: no accute process, maximum age 60 years, no suspicion of choledocolithiasis and classification ASA I and 11. The surgery was performed in lithotomy position with three trocars. Cholangiography was routine. Surgical time ranged from 20 to 80 minutes with an average of 50. Cholangiography was done in 105 cases (87.5%) confirming choledocolithiasis in two (1.9%). There were no conversions. The most common complications in the imediate postoperative period were: nausea in eight patients (6.6%) with vomiting in two (1.6%). The abdominal pain was little and easily treated with dipiron and nonsteroidal antiinflammatory analgesics. Operatory wound infection was not observed but three patients (2.5%) showed hyperemia in the umbilical incision. All patients were discharged from ambulatory after an average hospitalar stay of ten hours. In conclusion, according to what this study has shown laparoscopic cholecystectomy can perfectly be done in the ambulatory setting without increasing on the complication rates.