Factors responsible for prolonged postoperative hospital stay after laparoscopic cholecystectomy
Abstract
Objective: To identify various factors which prolong post-operative hospital stay after laparoscopic cholecystectomy.
Methodology: This is an observational prospective study conducted at a teaching hospital over a period of five years (Jan 2005-Dec 2010) and includes 580 patients of symptomatic cholelithiasis, admitted and treated by laparoscopic surgery. All patients were observed from 1st postoperative day to date of discharge and different operative, postoperative and patient related variables were recorded on a proforma which were found responsible for an unduly prolonged post-operative stay in the hospital. The duration decided for short stay was 48 hours and duration more than that was considered as prolonged stay.
Results: Out of 580 patients, 187 (32.24%) had prolonged stay extending from 3-28 days. Majority of patients presented in 4th & 5th decade (60.52%) with pain in right hypochondrium (58.79%) and pain in right hypochondrium combined with pain in epigastrium (27.6%) as main clinical features. Twenty eight variables were identified comprising of 10 patients related (15.86%), 12 surgery related (16.55%) and 6 post-surgery related (16.38%) which contributed to prolong the hospital stay. Patients having co morbid conditions, difficult operative procedure and major postoperative complications were main factors for prolonged stay.
Conclusion: The prolonged post-operative hospital stay can be reduced by careful pre-operative assessment, meticulous surgery and proper post-operative management.
Methodology: This is an observational prospective study conducted at a teaching hospital over a period of five years (Jan 2005-Dec 2010) and includes 580 patients of symptomatic cholelithiasis, admitted and treated by laparoscopic surgery. All patients were observed from 1st postoperative day to date of discharge and different operative, postoperative and patient related variables were recorded on a proforma which were found responsible for an unduly prolonged post-operative stay in the hospital. The duration decided for short stay was 48 hours and duration more than that was considered as prolonged stay.
Results: Out of 580 patients, 187 (32.24%) had prolonged stay extending from 3-28 days. Majority of patients presented in 4th & 5th decade (60.52%) with pain in right hypochondrium (58.79%) and pain in right hypochondrium combined with pain in epigastrium (27.6%) as main clinical features. Twenty eight variables were identified comprising of 10 patients related (15.86%), 12 surgery related (16.55%) and 6 post-surgery related (16.38%) which contributed to prolong the hospital stay. Patients having co morbid conditions, difficult operative procedure and major postoperative complications were main factors for prolonged stay.
Conclusion: The prolonged post-operative hospital stay can be reduced by careful pre-operative assessment, meticulous surgery and proper post-operative management.
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