Feasibility and safety of laparoscopic cholecystectomy in same-day surgery model_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CAO Junqiu ^1,2 , XIONG Huan ¹ , SONG Yinghan ^1,2 , WANG Xiaocheng ^1,2 , FANG Lu ^1,2 , XING Yuling ^1,2 , CHEN Hongyu ^3,4 , ZHAO Xiaoyan ^1,2 , LIANG Peng ² , MA Hongsheng ^1,2 ,  CHEN Yonghua ^3,4

1. Day Surgery Center, West China Tianfu Hospital, Sichuan University, Chengdu 610213, P. R. China;
2. Day Surgery Center, General Practicc Medical Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. Department of Hepatobiliary and Pancreatic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu 610213, P. R. China;

Corresponding?author：

CHEN Yonghua, Email: 13699410525@163.com

Keywords：

laparoscopic cholecystectomy; same-day surgery; day surgery; clinical application; safety

DOI：

10.7507/1007-9424.202501106

Video：

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Objective To evaluate the feasibility and safety of laparoscopic cholecystectomy (LC) in same-day surgery model. Methods The patients who underwent LC at West China Tianfu Hospital of Sichuan University from November 1, 2023 to July 31, 2024, were retrospectively reviewed. The enrolled patients were divided into a same-day surgery LC group (observation group) and a conventional inpatient LC group (control group). In the observation group, a same-day discharge protocol was implemented, whereby patients were admitted, operated on and discharged on the same day, with discharge required no later than 21:00 without an overnight stay. The control group was managed according to the conventional model. A comparison was carried out between the two groups concerning perioperative outcomes, surgery-related complications, postoperative urinary retention, total length of stay, total hospitalization costs, and 30-day follow-up results. Results A total of 347 patients were included, comprising 164 in the observation group and 183 in the control group. No statistically significant differences (P>0.05) were found between the two groups in the following terms: total anesthesia time, operative time, intraoperative blood loss, intraoperative fluid infusion, length of stay in the post-anesthesia care unit (PACU), fluid infusion in the PACU, placement of intra-abdominal draining, pain visual analog scale score at discharge, rates of unplanned revisits and readmission due to changes in their disease condition within 30 d after discharge, and the incidence of surgery-related complications. All complications in both groups were graded as Clavien-Dindo Ⅰ. The observation group demonstrated significantly lower or less preoperative fluid infusion, postoperative fluid infusion, total hospitalization costs, and a shorter total length of stay as compared with the control group (P<0.05). Furthermore, the incidence of postoperative urinary retention was significantly lower in the observation group as compared with the control group (P<0.05). Conclusions This study demonstrates that same-day surgery LC is a safe and feasible approach for appropriately selected patients. Its outcomes in key perioperative safety metrics are comparable to those of the conventional inpatient LC model, while it offers the significant advantages of effectively reducing the length of hospital stay, lowering medical costs, and decreasing the incidence of certain postoperative complications.

Citation： CAO Junqiu, XIONG Huan, SONG Yinghan, WANG Xiaocheng, FANG Lu, XING Yuling, CHEN Hongyu, ZHAO Xiaoyan, LIANG Peng, MA Hongsheng, CHEN Yonghua. Feasibility and safety of laparoscopic cholecystectomy in same-day surgery model. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(11): 1437-1442. doi: 10.7507/1007-9424.202501106 Copy

1.	No authors listed. Guidelines for office-based surgery: quality assurance. ACS Board of Governors’ Committee on ambulatory surgical care. Bull Am Coll Surg, 1994, 79(10): 32-34.
2.	Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
3.	Burn JM. A blueprint for day surgery. Anaesthesia, 1979, 34(8): 790-805.
4.	Stephens FO. Day stay, ambulatory or outpatient surgery. Med J Aust, 1994, 160(3): 99-100.
5.	劉蔚東主編. 日間手術管理. 北京: 人民衛生出版社, 2025.
6.	蔣麗莎, 馬洪升. 日歸手術—中國日間手術的升華. 華西醫學, 2022, 37(2): 161-164.
7.	Xiong W, Li M, Wang M, et al. The safety of laparoscopic cholecystectomy in the day surgery unit comparing with that in the inpatient unit: a systematic review and meta-analysis. Biomed Res Int, 2020, 2020: 1924134. doi: 10.1155/2020/1924134.
8.	中國研究型醫院學會微創外科學專業委員會. 日間腹腔鏡膽囊切除術專家共識. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
9.	Tenconi SM, Boni L, Colombo EM, et al. Laparoscopic cholecystectomy as day-surgery procedure: current indications and patients’ selection. Int J Surg, 2008: 6 Suppl 1: S86-S88. doi: 10.1016/j.ijsu.2008.12.032.
10.	Cassinotti E, Colombo EM, Di Giuseppe M, et al. Current indications for laparoscopy in day-case surgery. Int J Surg, 2008: 6 Suppl 1: S93-S96. doi: 10.1016/j.ijsu.2008.12.012.
11.	沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的Meta分析. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
12.	李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的Meta分析. 中華普通外科學文獻(電子版), 2018, 12(6): 444-450.
13.	魯發順, 鐘鍇, 穆熱艾合買提江·穆塔里夫, 等. 日間模式應用于腹腔鏡膽囊切除術的療效分析. 中國普外基礎與臨床雜志, 2021, 28(7): 856-860.
14.	曹嶸, 王貴陽, 李可為, 等. 單中心317例日間單孔腹腔鏡膽囊切除術臨床療效分析. 肝膽胰外科雜志, 2021, 33(12): 750-754.
15.	Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2014, 118(1): 85-113.
16.	Chung F, Chan VW, Ong D. A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth, 1995, 7(6): 500-506.
17.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
18.	Kim SS, Donahue TR. Laparoscopic cholecystectomy. JAMA, 2018, 319(17): 1834. doi: 10.1001/jama.2018.3438.
19.	Curtis NJ, Robinson PD, Carty NJ. Single hospital visit elective day-case laparoscopic cholecystectomy without prior outpatient attendance. Surg Endosc, 2017, 31(9): 3574-3580.
20.	雷甜甜, 黃明君, 梁鵬 , 等. 日間手術精準排程的研究現狀及進展. 華西醫學, 2024, 39(2): 308-312.
21.	Gregori M, Miccini M, Biacchi D, et al. Day case laparoscopic cholecystectomy: safety and feasibility in obese patients. Int J Surg, 2018, 49: 22-26.
22.	Tandon A, Sunderland G, Nunes QM, et al. Day case laparoscopic cholecystectomy in patients with high BMI: experience from a UK centre. Ann R Coll Surg Engl, 2016, 98(5): 329-333.
23.	Johansson M, Thune A, Nelvin L, et al. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy. Br J Surg, 2006, 93(1): 40-45.
24.	Hollington P, Toogood GJ, Padbury RT. A prospective randomized trial of day-stay only versus overnight-stay laparoscopic cholecystectomy. Aust N Z J Surg, 1999, 69(12): 841-843.
25.	Keulemans Y, Eshuis J, de Haes H, et al. Laparoscopic cholecystectomy: day-care versus clinical observation. Ann Surg, 1998, 228(6): 734-740.
26.	Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg, 2017, 152(3): 292-298.
27.	Ghosh-Dastidar MB, Deshpande RP, Rajagopal K, et al. Day surgery unit thoracic surgery: the first UK experience. Eur J Cardiothorac Surg, 2011, 39(6): 1047-1050.
28.	Wang L, Baser O, Wells P, et al. Benefit of early discharge among patients with low-risk pulmonary embolism. PLoS One, 2017, 12(10): e0185022. doi: 10.1371/journal.pone.0185022.
29.	Gilmartin J, Wright K. The nurse’s role in day surgery: a literature review. Int Nurs Rev, 2007, 54(2): 183-190.
30.	劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范. 華西醫學, 2019, 34(2): 137-139.

1. No authors listed. Guidelines for office-based surgery: quality assurance. ACS Board of Governors’ Committee on ambulatory surgical care. Bull Am Coll Surg, 1994, 79(10): 32-34.
2. Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
3. Burn JM. A blueprint for day surgery. Anaesthesia, 1979, 34(8): 790-805.
4. Stephens FO. Day stay, ambulatory or outpatient surgery. Med J Aust, 1994, 160(3): 99-100.
5. 劉蔚東主編. 日間手術管理. 北京: 人民衛生出版社, 2025.
6. 蔣麗莎, 馬洪升. 日歸手術—中國日間手術的升華. 華西醫學, 2022, 37(2): 161-164.
7. Xiong W, Li M, Wang M, et al. The safety of laparoscopic cholecystectomy in the day surgery unit comparing with that in the inpatient unit: a systematic review and meta-analysis. Biomed Res Int, 2020, 2020: 1924134. doi: 10.1155/2020/1924134.
8. 中國研究型醫院學會微創外科學專業委員會. 日間腹腔鏡膽囊切除術專家共識. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
9. Tenconi SM, Boni L, Colombo EM, et al. Laparoscopic cholecystectomy as day-surgery procedure: current indications and patients’ selection. Int J Surg, 2008: 6 Suppl 1: S86-S88. doi: 10.1016/j.ijsu.2008.12.032.
10. Cassinotti E, Colombo EM, Di Giuseppe M, et al. Current indications for laparoscopy in day-case surgery. Int J Surg, 2008: 6 Suppl 1: S93-S96. doi: 10.1016/j.ijsu.2008.12.012.
11. 沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的Meta分析. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
12. 李龍, 焦作義, 羅長江. 日間手術腹腔鏡膽囊切除術療效和安全性的Meta分析. 中華普通外科學文獻(電子版), 2018, 12(6): 444-450.
13. 魯發順, 鐘鍇, 穆熱艾合買提江·穆塔里夫, 等. 日間模式應用于腹腔鏡膽囊切除術的療效分析. 中國普外基礎與臨床雜志, 2021, 28(7): 856-860.
14. 曹嶸, 王貴陽, 李可為, 等. 單中心317例日間單孔腹腔鏡膽囊切除術臨床療效分析. 肝膽胰外科雜志, 2021, 33(12): 750-754.
15. Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2014, 118(1): 85-113.
16. Chung F, Chan VW, Ong D. A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth, 1995, 7(6): 500-506.
17. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
18. Kim SS, Donahue TR. Laparoscopic cholecystectomy. JAMA, 2018, 319(17): 1834. doi: 10.1001/jama.2018.3438.
19. Curtis NJ, Robinson PD, Carty NJ. Single hospital visit elective day-case laparoscopic cholecystectomy without prior outpatient attendance. Surg Endosc, 2017, 31(9): 3574-3580.
20. 雷甜甜, 黃明君, 梁鵬 , 等. 日間手術精準排程的研究現狀及進展. 華西醫學, 2024, 39(2): 308-312.
21. Gregori M, Miccini M, Biacchi D, et al. Day case laparoscopic cholecystectomy: safety and feasibility in obese patients. Int J Surg, 2018, 49: 22-26.
22. Tandon A, Sunderland G, Nunes QM, et al. Day case laparoscopic cholecystectomy in patients with high BMI: experience from a UK centre. Ann R Coll Surg Engl, 2016, 98(5): 329-333.
23. Johansson M, Thune A, Nelvin L, et al. Randomized clinical trial of day-care versus overnight-stay laparoscopic cholecystectomy. Br J Surg, 2006, 93(1): 40-45.
24. Hollington P, Toogood GJ, Padbury RT. A prospective randomized trial of day-stay only versus overnight-stay laparoscopic cholecystectomy. Aust N Z J Surg, 1999, 69(12): 841-843.
25. Keulemans Y, Eshuis J, de Haes H, et al. Laparoscopic cholecystectomy: day-care versus clinical observation. Ann Surg, 1998, 228(6): 734-740.
26. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg, 2017, 152(3): 292-298.
27. Ghosh-Dastidar MB, Deshpande RP, Rajagopal K, et al. Day surgery unit thoracic surgery: the first UK experience. Eur J Cardiothorac Surg, 2011, 39(6): 1047-1050.
28. Wang L, Baser O, Wells P, et al. Benefit of early discharge among patients with low-risk pulmonary embolism. PLoS One, 2017, 12(10): e0185022. doi: 10.1371/journal.pone.0185022.
29. Gilmartin J, Wright K. The nurse’s role in day surgery: a literature review. Int Nurs Rev, 2007, 54(2): 183-190.
30. 劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范. 華西醫學, 2019, 34(2): 137-139.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Feasibility and safety of laparoscopic cholecystectomy in same-day surgery model

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