Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study.
We evaluated conventional overnight-stay laparoscopic cholecystectomy, focusing on the preoperative admission day, to assess the feasibility of implementing daycare laparoscopic cholecystectomy, which is currently underutilized in developing and some Asian countries. We retrospectively reviewed elec...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293446&type=printable |
| _version_ | 1797640172530040832 |
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| author | Suppadech Tunruttanakul Ratchanee Tunruttanakul Kamoltip Prasopsuk Kwanhathai Sakulsansern Kyrhatii Trikhirhisthit |
| author_facet | Suppadech Tunruttanakul Ratchanee Tunruttanakul Kamoltip Prasopsuk Kwanhathai Sakulsansern Kyrhatii Trikhirhisthit |
| author_sort | Suppadech Tunruttanakul |
| collection | DOAJ |
| description | We evaluated conventional overnight-stay laparoscopic cholecystectomy, focusing on the preoperative admission day, to assess the feasibility of implementing daycare laparoscopic cholecystectomy, which is currently underutilized in developing and some Asian countries. We retrospectively reviewed elective laparoscopic cholecystectomy data from March 2020 to February 2022 at a 700-bed tertiary hospital in Thailand. Variables included age, sex, body mass index, comorbidities, American Society of Anesthesiologists status, presence of preoperative anesthesiology visit, laparoscopic cholecystectomy indications, additional intraoperative cholangiography, and surgery cancellations. The primary focus was on preoperative treatment and monitoring needs; secondary outcomes included morbidity, mortality within 30 days, and prolonged hospital stay (>48 hours). Statistical analysis was conducted using the Fisher exact test, t-test, and logistic regression. The study included 405 patients. Of these, 65 (16.1%) received preoperative treatment, with 21 unnecessary (over) treatments and six under-treatments. Based on the results, approximately 12.1% (n = 49) of patients may have theoretically required preoperative admission and treatment. Multivariable analysis showed that the increasing of comorbidities was significantly associated with preoperative management (odds ratio [95% Confidence interval]: 7.0 [2.1, 23.1], 23.9 [6.6, 86.6], 105.5 [17.5, 636.6]) for one, two, and three comorbidities, respectively), but factors such as age, obesity, and American Society of Anesthesiologists status were not. The cohort had 4.2% morbidity (2.2% medical complications), with no mortality. Surgery cancellations occurred in 0.5%. In conclusion, on the basis of our data, a small proportion (12.1%) of patients undergoing elective laparoscopic cholecystectomy may require preoperative admissions to receive the necessary treatment, and most (87.9%) preoperative admissions may not provide treatment benefit. The traditional admission approach was safe but required re-evaluation for optimal resource management. |
| first_indexed | 2024-03-11T13:28:05Z |
| format | Article |
| id | doaj.art-0bdc356fffb448eab3ba41225a2beb0b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-11T13:28:05Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-0bdc356fffb448eab3ba41225a2beb0b2023-11-03T05:32:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011810e029344610.1371/journal.pone.0293446Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study.Suppadech TunruttanakulRatchanee TunruttanakulKamoltip PrasopsukKwanhathai SakulsansernKyrhatii TrikhirhisthitWe evaluated conventional overnight-stay laparoscopic cholecystectomy, focusing on the preoperative admission day, to assess the feasibility of implementing daycare laparoscopic cholecystectomy, which is currently underutilized in developing and some Asian countries. We retrospectively reviewed elective laparoscopic cholecystectomy data from March 2020 to February 2022 at a 700-bed tertiary hospital in Thailand. Variables included age, sex, body mass index, comorbidities, American Society of Anesthesiologists status, presence of preoperative anesthesiology visit, laparoscopic cholecystectomy indications, additional intraoperative cholangiography, and surgery cancellations. The primary focus was on preoperative treatment and monitoring needs; secondary outcomes included morbidity, mortality within 30 days, and prolonged hospital stay (>48 hours). Statistical analysis was conducted using the Fisher exact test, t-test, and logistic regression. The study included 405 patients. Of these, 65 (16.1%) received preoperative treatment, with 21 unnecessary (over) treatments and six under-treatments. Based on the results, approximately 12.1% (n = 49) of patients may have theoretically required preoperative admission and treatment. Multivariable analysis showed that the increasing of comorbidities was significantly associated with preoperative management (odds ratio [95% Confidence interval]: 7.0 [2.1, 23.1], 23.9 [6.6, 86.6], 105.5 [17.5, 636.6]) for one, two, and three comorbidities, respectively), but factors such as age, obesity, and American Society of Anesthesiologists status were not. The cohort had 4.2% morbidity (2.2% medical complications), with no mortality. Surgery cancellations occurred in 0.5%. In conclusion, on the basis of our data, a small proportion (12.1%) of patients undergoing elective laparoscopic cholecystectomy may require preoperative admissions to receive the necessary treatment, and most (87.9%) preoperative admissions may not provide treatment benefit. The traditional admission approach was safe but required re-evaluation for optimal resource management.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293446&type=printable |
| spellingShingle | Suppadech Tunruttanakul Ratchanee Tunruttanakul Kamoltip Prasopsuk Kwanhathai Sakulsansern Kyrhatii Trikhirhisthit Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. PLoS ONE |
| title | Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. |
| title_full | Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. |
| title_fullStr | Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. |
| title_full_unstemmed | Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. |
| title_short | Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study. |
| title_sort | preoperative admission is non essential in most patients receiving elective laparoscopic cholecystectomy a cohort study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293446&type=printable |
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