scholarly journals 811 Should We Be Performing Day Case Laparoscopic Cholecystectomy (DCLC) After 3pm? Correlation Between Time of Operation and Post-Operative Hospital Stay

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Alamassi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operation Time ◽  
Day Surgery ◽  
Inpatient Admission ◽  
Multiple Sources ◽  
Timing Of Operation ◽  
Performance Targets ◽  
National Performance ◽  
Unplanned Admissions ◽  
Time Of Operation

Abstract Introduction Laparoscopic cholecystectomy (LC) is a common daycase procedure. The British Association of Day Surgery (BADS) Procedure Directory sets out national performance targets for the number of LC’s treated as day cases. This study aimed to assess if operation time predicted unplanned inpatient admission. Method An annonymised retrospective review of all patients undergoing LC. The data was undertaken over two cycles. The first cycle was a 6-month period followed by a second cycle that was undertaken over three months. Data was obtained from multiple sources: discharge letters and the theatre data manager. Results Total number of cases was 160. In the first cycle, the zero night stay for DCLC was 56%, which lies within the top 50% of current national performance but is below the BADS target of 75%. In the second cycle, the zero-night stay was 70%, which falls just below the BADS target. While unplanned admissions resembled 30%. We had 136 cases underwent LC before 3 pm. While 24 cases had their operation after 3 pm. 19 patients out of those 24 stayed at the hospital. Conclusions The timing of operation of DCLC predicts inpatient admission; our data suggests that DCLC should not take place after 3pm in the afternoon.

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

An Intelligent Patient Admission Model of Day Surgery Using Heterogeneous Data with Semi-Supervised Learning: A Case Study of Laparoscopic Cholecystectomy (Preprint)

2021 ◽  
Author(s):  
Wenchang Li ◽  
Lisha Jiang ◽  
Hongwei Shi ◽  
Hongsheng Ma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Scientific Evidence ◽  
Patient Characteristics ◽  
Day Surgery ◽  
Heterogeneous Data ◽  
Patient Admission ◽  
Admission Criteria ◽  
Important Indicator ◽  
Medical Quality ◽  
Admission Decisions

BACKGROUND Day surgery has many advantages including shortening hospital stay, decreasing the risk of hospital-associated infections, and increasing cost efficiency over traditional surgery, it has gained a great reputation and popularity in recent years. However, the patients’ admission criteria of day surgery at present were mainly based on expert experience, which was a lack of scientific evidence. OBJECTIVE Our study is to investigate the day surgery patient’s admission criteria and build an intelligent machine learning model of day surgery patients who underwent laparoscopic cholecystectomy, to ensure patients’ safety and medical quality, providing reference and inspiration for other day surgery admission decisions. METHODS We analyzed the clinical data of day surgery patients who underwent laparoscopic cholecystectomy at West China Hospital from Jan 1st 2009 to Dec 31st 2021 and developed a semi-supervised artificial intelligence algorithm, SDSPA algorithm, which is built by self-training and uses both structured data like patient characteristics and unstructured clinical diagnosis to assist surgeons to make quick admission decisions. RESULTS After comparing several classifiers with self-training in our experiment, the performance of LightGBM with unstructured text processed by BERT were the best, obtaining an accuracy of 0.85 and an f1-score of 0.83, as well as reaching 0.97 on the precision score, which is an important indicator related to patients’ safety. CONCLUSIONS The application of our SDSPA algorithm can make the patient admission of day surgery more intelligent, and maximize the utilization of medical resources while ensuring patients’ safety.

scholarly journals A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in Day Surgery Mode

2020 ◽  
Author(s):  
Xiao-Liang Zhu ◽  
Song-Jiang Wu ◽  
Yasmeen Bano ◽  
Wen-Li Liu ◽  
Ming-Hui jiang ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Previous History ◽  
Operation Time ◽  
Renal Cysts ◽  
Day Surgery ◽  
Simple Renal Cyst ◽  
Inpatient Ward ◽  
Medical Environment ◽  
History Of ◽  
Retroperitoneal Laparoscopy

Abstract Background: Under the constraints of the increasingly tight medical environment and cost, day surgery mode has become a favorable trend and attracts attention from clinicians. Currently, there are no standards or procedures on the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in day surgery mode. We attempted to investigate the feasibility and safety criteria of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day surgery ward and to compare the advantages and the disadvantages with conventional inpatient ward mode.Methods: A total of 41 patients with unilateral simple renal cysts meeting surgical indications were enrolled in this study. To see whether patients in the day group could successfully complete the procedure and be admitted and discharged within 24 hours and to summarize the advantages and the advantages. The indexes of the operation time, time of hospitalization, postoperative complication rate, total costs of hospitalization and other indicators were compared between the two groups.Results: 41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10-12 months after surgery. The results of time of hospitalization, total costs of hospitalization and time of postoperative removal of drainage tube were statistically significant between the two groups of the day ward group and the inpatient ward group (P <0.05). Conclusions: We concluded the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients with unilateral renal cysts was safe and feasible in day surgery mode under certain indicative criteria. The criteria included patients’ age between 40 and 80 years, no previous history of abdominal surgery, CT showing a unilateral renal cyst (Bosniak I or II), preoperative ASA assessment was I or II, no contraindications to surgery or anesthesia, postoperative team management and discharge assessment. Advantage of reducing time of hospitalization and total medical cost may relieve the situation of the shortage of medical resources.

Comparative Study of Standard Four-Port, Three Port and Single Incision Laparoscopic Cholecystectomy Performed by a Single Surgeon in Nobel Medical College Teaching Hospital, Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1325-1329
Author(s):  
Ruslan Sulaimankulov ◽  
Gulmira Jolochieva
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Teaching Hospital ◽  
Operative Procedure ◽  
College Teaching ◽  
Operation Time ◽  
Scarless Surgery ◽  
Group Iii ◽  
Medical College ◽  
Group I ◽  
Hospital Stays

Introduction: Laparoscopic Cholecystectomy is a standard operative procedure for patients with gallbladder diseases and is the most common laparoscopic procedure performed worldwide. The aim of this study is to analyze the different methods of laparoscopic cholecystectomies done by a single surgeon at Nobel Medical College Teaching Hospital. Objectives: The objective and aim of this study are comparing 4 port classic Laparoscopic Cholecystectomy (4PLC), 3 port (3PLC) and Laparo-Endoscopic Single-Site Cholecystectomy (LESC) performed by a single surgeon and correlate worldwide experience with outcomes in our institution. Methodology: The study includes retrospective analysis of 8192 patients who underwent elective laparoscopic Cholecystectomy (LC) from October 2010 to July 2020 performed by the single surgeon. All cases divided into 3 groups depending on the type of LC (4PLC, 3PLC, LESC). The data included the type of the surgery, gender, age, operative time, conversion and complication rate and duration of hospital stay. Results: The hospital stays, operation time and conversion rate decreased from group I to group III. Female patients out numbered the male ones (M:F=1:4). The hospital stays (3.4 days), operation time (35 min), conversion (0.4%) and complications (0.7%) rate decreased from Group of 4PLC to Group of LESC (1.5 days, 13 min, 0.1% conversion, 0.4% complication respectively) which is true for almost all other similar studies. Conclusion: The advantages of LESC include a better cosmetic effect and reduced chance of infections. It has been postulated to be superior in scarless surgery with added benefits of lower pain level and reduced need for analgesics, shorter hospital stays, quicker return to work and lower financial expenses. 

scholarly journals Laparoscopic cholecystectomy as day-surgery procedure: Current indications and patients' selection

2008 ◽  
Vol 6 ◽  
pp. S86-S88 ◽  
Author(s):  
S.M. Tenconi ◽  
L. Boni ◽  
E.M. Colombo ◽  
G. Dionigi ◽  
F. Rovera ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Day Surgery

8 Video laparoscopic cholecystectomy in Day Surgery

2005 ◽  
Vol 12 ◽  
pp. S3-S3
Author(s):  
R MONZANI ◽  
F CARRERA ◽  
S BONA
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Day Surgery

Role of Ultrasound Screening for Gallbladder Disease in Pretransplant Patients

2008 ◽  
Vol 74 (9) ◽  
pp. 832-833
Author(s):  
Madhavi Meka ◽  
Santosh Potdar ◽  
Peter Benotti ◽  
J. Edward Hartle ◽  
Christopher Senkowski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Disease ◽  
Graft Loss ◽  
Day Surgery ◽  
Control Group ◽  
Study Group ◽  
Gallstone Pancreatitis ◽  
Safe Procedure ◽  
Ultrasound Screening ◽  
Clinical Value

There is no uniform data regarding prophylactic cholecystectomy in patients undergoing renal transplantation with gallbladder disease. Data analyses suggest that posttransplant patients on cyclosporine have a higher incidence of gallbladder calcifications compared with nonimmunosuppressed patients. Laparoscopic cholecystectomy is a relatively safe procedure in modern-day surgery. Taking these facts into consideration, we attempted to compare risks and complications associated with gallbladder disease and eventual cholecystectomy in pretransplant versus post-transplant patients. Between June 1999 and December 2005, 210 renal transplants were performed at our institution. One hundred four patients who had transplants before April 2003 were not screened for gallbladder disease and nine of these patients developed gallbladder disease. These patients form our control group. One hundred six patients who had transplants after April 2003 had pretransplant screening for gallbladder disease and 11 patients were identified with gallbladder disease. These patients form our study group. Nine patients who developed gallbladder disease after renal transplant underwent laparoscopic cholecystectomy with three resulting morbidities (33%), two graft losses (22%), and one mortality (11%). There was one mortality (11%) in this group. One patient in the study group died of acute gallstone pancreatitis. Of the 11 patients who were found to have gallbladder disease on screening, nine patients underwent laparoscopic cholecystectomy with one morbidity and no mortality or graft loss. Given the relative rarity of the critical events in this study (morbidity, mortality, and graft loss), the definitive statistical value of prescreening for gallbladder disease cannot be established. However, our results are suggestive of clinical value and thus we tentatively recommend ultrasound screening for gallbladder disease for all pretransplant patients and laparoscopic cholecystectomy for those identified to have gallbladder disease.

scholarly journals 262 Analysis of the Factors Contributing to Unplanned Admissions of Surgical Day Cases

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Al-Zubaidy ◽  
C Greaney ◽  
H Malik ◽  
F Awan
Keyword(s):  
Admission Rate ◽  
Incisional Hernia Repair ◽  
Cost Effective ◽  
Day Surgery ◽  
Root Cause ◽  
Background History ◽  
Unanticipated Admission ◽  
Almost All ◽  
Unplanned Admissions ◽  
Hospital Acquired

Abstract Introduction Day surgery has many benefits including a reduction in waiting lists, cancellations, hospital acquired infections and need for inpatient beds. It is also highly cost effective. The aim of this study is to identify which factors lead to the unanticipated admission of day cases, in order to adjust future patient selection, and retain efficiency Method A list of day cases that took place in 2017 was obtained from the HIPE department in St. Luke’s General Hospital. Day case patients who required admission were retrospectively analysed with the use of patient charts. Patient factors such as age, gender and co morbidities were recorded. The root cause of admission was identified, and the data collated. Results 457-day cases took place during 2017. 35/457 patients were admitted postoperatively (admission rate of 7.8%). The majority of patients were admitted post cholecystectomy (22) and incisional hernia repair (8). Surgical factors were responsible for almost all admissions. Conclusions Surgical factors/complications are not always predictable, but a thorough review of a patient’s background history and imaging can lead to the identification of patients, who should be directed away from day surgery, minimising the need for unexpected admissions, and maximising the efficiency of the unit.

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