A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy
Background Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients. Methods A systematic review of Cochrane, Embase, and Medline using the keywords “ambulatory,” “laparoscopic,” and “cholecystectomy” was...
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| Veröffentlicht in: | Surgical endoscopy 2008-09, Vol.22 (9), p.1928-1934 |
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| creator | Ahmad, N. Z. Byrnes, G. Naqvi, S. A. |
| description | Background
Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients.
Methods
A systematic review of Cochrane, Embase, and Medline using the keywords “ambulatory,” “laparoscopic,” and “cholecystectomy” was performed. Postoperative complications leading to admissions and readmissions were compared between day care and inpatient laparoscopic cholecystectomy groups. Postoperative quality of life, patient satisfaction, and cost effectiveness also were analyzed.
Results
The search process identified seven clinical trials suitable for meta-analysis. These trials, consisting of 598 patients, compared day care and inpatient procedures. The unplanned admission rate in the ambulatory group was comparable with the prolonged hospitalization of inpatients (odds ratio [OR], 1.979; 95% confidence interval [CI], 0.846–4.628). There was no significant difference between the readmission rates of the two groups (OR, 0.964; 95% CI, 0.318–2.922). The quality-of-life indicators were similar for the ambulatory and overnight-stay patients (
p
= 0.195). The cost effectiveness was better for the day care procedures because of the shorter mean hospital stay.
Conclusion
Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction. |
| doi_str_mv | 10.1007/s00464-008-9867-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69498218</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1548139881</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-528f94261b61d29f7ab165fa53a65fc3dc5b7525621fccc9dfc68d614456265b3</originalsourceid><addsrcrecordid>eNp1kM1q3TAQRkVJaG5u-wDdFBNIdkolWZKtZQj5I4Fs2rUYy1LjYFuuxg747aNwLwkUshrQnG9Gcwj5wdk5Z6z6hYxJLSljNTW1rqj4QjZcloIKwesDsmGmZFRURh6RY8RnlnHD1VdyxOsyB2S9IfcXxeBnoDBCv2KHRQwFDM3SwxzTWrz4hAsW3TjB3PlxLnqYIEV0cepc4Z5i792Ks3dzHNZv5DBAj_77vm7Jn-ur35e39OHx5u7y4oG60piZKlEHI4XmjeatMKGChmsVQJWQiytbp5pKCaUFD8450wan61ZzKfOTVk25JWe7uVOK_xaPsx06dL7vYfRxQauNNHU2kMGT_8DnuKR8KVrBjVSCS5MhvoNcvguTD3ZK3QBptZzZN812p9lmzfZNsxU583M_eGkG334k9l4zcLoHAB30IcHoOnznBNO6FJXKnNhxmFvjX58-fvj59lf2jZUN</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219452149</pqid></control><display><type>article</type><title>A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Ahmad, N. Z. ; Byrnes, G. ; Naqvi, S. A.</creator><creatorcontrib>Ahmad, N. Z. ; Byrnes, G. ; Naqvi, S. A.</creatorcontrib><description>Background
Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients.
Methods
A systematic review of Cochrane, Embase, and Medline using the keywords “ambulatory,” “laparoscopic,” and “cholecystectomy” was performed. Postoperative complications leading to admissions and readmissions were compared between day care and inpatient laparoscopic cholecystectomy groups. Postoperative quality of life, patient satisfaction, and cost effectiveness also were analyzed.
Results
The search process identified seven clinical trials suitable for meta-analysis. These trials, consisting of 598 patients, compared day care and inpatient procedures. The unplanned admission rate in the ambulatory group was comparable with the prolonged hospitalization of inpatients (odds ratio [OR], 1.979; 95% confidence interval [CI], 0.846–4.628). There was no significant difference between the readmission rates of the two groups (OR, 0.964; 95% CI, 0.318–2.922). The quality-of-life indicators were similar for the ambulatory and overnight-stay patients (
p
= 0.195). The cost effectiveness was better for the day care procedures because of the shorter mean hospital stay.
Conclusion
Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-008-9867-2</identifier><identifier>PMID: 18398648</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject><![CDATA[Abdominal Surgery ; Adult ; Ambulatory Surgical Procedures - economics ; Ambulatory Surgical Procedures - statistics & numerical data ; Biological and medical sciences ; Cholecystectomy, Laparoscopic - economics ; Cholecystectomy, Laparoscopic - statistics & numerical data ; Cholecystitis - economics ; Cholecystitis - surgery ; Clinical Trials as Topic - statistics & numerical data ; Cost-Benefit Analysis ; Digestive system. Abdomen ; Elective Surgical Procedures - statistics & numerical data ; Endoscopy ; Female ; Gastroenterology ; General aspects ; Gynecology ; Hepatology ; Hospitalization - economics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Length of Stay - statistics & numerical data ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Patient Admission - statistics & numerical data ; Patient Satisfaction ; Postoperative Complications - epidemiology ; Proctology ; Review ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system]]></subject><ispartof>Surgical endoscopy, 2008-09, Vol.22 (9), p.1928-1934</ispartof><rights>Springer Science+Business Media, LLC 2008</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-528f94261b61d29f7ab165fa53a65fc3dc5b7525621fccc9dfc68d614456265b3</citedby><cites>FETCH-LOGICAL-c399t-528f94261b61d29f7ab165fa53a65fc3dc5b7525621fccc9dfc68d614456265b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-008-9867-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-008-9867-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20663275$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18398648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ahmad, N. Z.</creatorcontrib><creatorcontrib>Byrnes, G.</creatorcontrib><creatorcontrib>Naqvi, S. A.</creatorcontrib><title>A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients.
Methods
A systematic review of Cochrane, Embase, and Medline using the keywords “ambulatory,” “laparoscopic,” and “cholecystectomy” was performed. Postoperative complications leading to admissions and readmissions were compared between day care and inpatient laparoscopic cholecystectomy groups. Postoperative quality of life, patient satisfaction, and cost effectiveness also were analyzed.
Results
The search process identified seven clinical trials suitable for meta-analysis. These trials, consisting of 598 patients, compared day care and inpatient procedures. The unplanned admission rate in the ambulatory group was comparable with the prolonged hospitalization of inpatients (odds ratio [OR], 1.979; 95% confidence interval [CI], 0.846–4.628). There was no significant difference between the readmission rates of the two groups (OR, 0.964; 95% CI, 0.318–2.922). The quality-of-life indicators were similar for the ambulatory and overnight-stay patients (
p
= 0.195). The cost effectiveness was better for the day care procedures because of the shorter mean hospital stay.
Conclusion
Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Ambulatory Surgical Procedures - economics</subject><subject>Ambulatory Surgical Procedures - statistics & numerical data</subject><subject>Biological and medical sciences</subject><subject>Cholecystectomy, Laparoscopic - economics</subject><subject>Cholecystectomy, Laparoscopic - statistics & numerical data</subject><subject>Cholecystitis - economics</subject><subject>Cholecystitis - surgery</subject><subject>Clinical Trials as Topic - statistics & numerical data</subject><subject>Cost-Benefit Analysis</subject><subject>Digestive system. Abdomen</subject><subject>Elective Surgical Procedures - statistics & numerical data</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patient Satisfaction</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Review</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kM1q3TAQRkVJaG5u-wDdFBNIdkolWZKtZQj5I4Fs2rUYy1LjYFuuxg747aNwLwkUshrQnG9Gcwj5wdk5Z6z6hYxJLSljNTW1rqj4QjZcloIKwesDsmGmZFRURh6RY8RnlnHD1VdyxOsyB2S9IfcXxeBnoDBCv2KHRQwFDM3SwxzTWrz4hAsW3TjB3PlxLnqYIEV0cepc4Z5i792Ks3dzHNZv5DBAj_77vm7Jn-ur35e39OHx5u7y4oG60piZKlEHI4XmjeatMKGChmsVQJWQiytbp5pKCaUFD8450wan61ZzKfOTVk25JWe7uVOK_xaPsx06dL7vYfRxQauNNHU2kMGT_8DnuKR8KVrBjVSCS5MhvoNcvguTD3ZK3QBptZzZN812p9lmzfZNsxU583M_eGkG334k9l4zcLoHAB30IcHoOnznBNO6FJXKnNhxmFvjX58-fvj59lf2jZUN</recordid><startdate>20080901</startdate><enddate>20080901</enddate><creator>Ahmad, N. Z.</creator><creator>Byrnes, G.</creator><creator>Naqvi, S. A.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080901</creationdate><title>A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy</title><author>Ahmad, N. Z. ; Byrnes, G. ; Naqvi, S. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-528f94261b61d29f7ab165fa53a65fc3dc5b7525621fccc9dfc68d614456265b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Ambulatory Surgical Procedures - economics</topic><topic>Ambulatory Surgical Procedures - statistics & numerical data</topic><topic>Biological and medical sciences</topic><topic>Cholecystectomy, Laparoscopic - economics</topic><topic>Cholecystectomy, Laparoscopic - statistics & numerical data</topic><topic>Cholecystitis - economics</topic><topic>Cholecystitis - surgery</topic><topic>Clinical Trials as Topic - statistics & numerical data</topic><topic>Cost-Benefit Analysis</topic><topic>Digestive system. Abdomen</topic><topic>Elective Surgical Procedures - statistics & numerical data</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Patient Satisfaction</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Review</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ahmad, N. Z.</creatorcontrib><creatorcontrib>Byrnes, G.</creatorcontrib><creatorcontrib>Naqvi, S. A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ahmad, N. Z.</au><au>Byrnes, G.</au><au>Naqvi, S. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2008-09-01</date><risdate>2008</risdate><volume>22</volume><issue>9</issue><spage>1928</spage><epage>1934</epage><pages>1928-1934</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Laparoscopic cholecystectomy is increasingly used on an ambulatory basis. This study aimed to examine its effectiveness for carefully selected patients.
Methods
A systematic review of Cochrane, Embase, and Medline using the keywords “ambulatory,” “laparoscopic,” and “cholecystectomy” was performed. Postoperative complications leading to admissions and readmissions were compared between day care and inpatient laparoscopic cholecystectomy groups. Postoperative quality of life, patient satisfaction, and cost effectiveness also were analyzed.
Results
The search process identified seven clinical trials suitable for meta-analysis. These trials, consisting of 598 patients, compared day care and inpatient procedures. The unplanned admission rate in the ambulatory group was comparable with the prolonged hospitalization of inpatients (odds ratio [OR], 1.979; 95% confidence interval [CI], 0.846–4.628). There was no significant difference between the readmission rates of the two groups (OR, 0.964; 95% CI, 0.318–2.922). The quality-of-life indicators were similar for the ambulatory and overnight-stay patients (
p
= 0.195). The cost effectiveness was better for the day care procedures because of the shorter mean hospital stay.
Conclusion
Ambulatory laparoscopic cholecystectomy can be performed safely for selected patients, with reduced cost and a high level of patient satisfaction.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18398648</pmid><doi>10.1007/s00464-008-9867-2</doi><tpages>7</tpages></addata></record> |
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| ispartof | Surgical endoscopy, 2008-09, Vol.22 (9), p.1928-1934 |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Adult Ambulatory Surgical Procedures - economics Ambulatory Surgical Procedures - statistics & numerical data Biological and medical sciences Cholecystectomy, Laparoscopic - economics Cholecystectomy, Laparoscopic - statistics & numerical data Cholecystitis - economics Cholecystitis - surgery Clinical Trials as Topic - statistics & numerical data Cost-Benefit Analysis Digestive system. Abdomen Elective Surgical Procedures - statistics & numerical data Endoscopy Female Gastroenterology General aspects Gynecology Hepatology Hospitalization - economics Humans Investigative techniques, diagnostic techniques (general aspects) Length of Stay - statistics & numerical data Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Medicine Medicine & Public Health Middle Aged Patient Admission - statistics & numerical data Patient Satisfaction Postoperative Complications - epidemiology Proctology Review Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system |
| title | A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy |
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