Page 21 - World Journal of Laparoscopic Surgery

Hindrance to Day Care Laparoscopic Cholecystectomy in India
the ROC curve in our study, operating times more than 104 minutes In our study, 13 patients of the 59 patients who were
can be considered as a predictive factor for failure of DCLC. dischargeable at 24 hours were not discharged because of various
Acute cholecystitis had a significant association with factors such as continuation of IV antibiotics (1), logistic factor
dischargeability at 6 hours with a p value of 0.004. Patients with (insurance) (4), patient factor (1), presence of drain (5), social factor
acute cholecystitis might not be ideal candidate for day care such as patient living at a far distance (1), and as surgeon anticipated
surgeries and can be considered as exclusion criteria in selection complications (1).
of patients for DCLCs. Appropriate antibiotic usage, surgeon and patient awareness
Of all the factors accessed, difficulty of surgery and use of drain about the treatment protocols, and streamlining hospital processes
were found to have significant association with dischargeability of can mitigate some of these factors delaying discharge. This will
the patients at 24 hours. Sherigar et al. in their study showed 3.4% have a significant impact in cutting off the hospital costs as well as
readmission after discharge in the first phase due to wound related in preventing hospital-acquired infections.
problems and surgical complication (cystic artery pseudoaneurysm)
and 3.5% readmission in the second phase which was also due to AcknowledgMents
10
wound related problems and surgical complication (CBD injury). We are thankful to our statistician Mr Souvik Dutta who helped us
These findings are consistent with our results showing that the main immensely throughout the analysis for this study.
causes for the patients being nondischargeable even at 24 hours
are difficult surgeries and surgical complications. references
Of the total 88 patients, 60 patients were discharged at 24
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World Journal of Laparoscopic Surgery, Volume 13 Issue 1 (January–April 2020) 19