ONE-DAY SURGERY (SHORT TERM DEPARTMENT) IN THE TREATMENT OF PATIENTS SUFFERING FROM CHOLELITHIASIS

Introduction. Laparoscopic cholecystectomy was recognized as operation of choice in treatment of cholelithiasis. The terms of hospital treatment were maximum decreased with a widespread introduction of laparoscopic technologies in treatment of cholelithiasis. In USA, Japan, European countries the hospitalization after elective laparoscopic cholecystectomy may be no more than 24 hours. From 15 to 30% of laparoscopic cholecystectomies are carried out by “one day surgery” principles.

Materials and methods. In our hospital within the period from 2006 to 2011 there were carried out 4,533 laparoscopic cholecystectomies. There were operated 2,800 (61.8%) patients suffering from chronic cholelithiasis. 557 (12.3%) patients suffering from cholelithiasis were discharged from the hospital in 24 hours.

Results and discussion. There were planned 678 patients with cholelithiasis to be operated by “one day surgery”, but operation and treatment within this term took place in 557 patients. With raising experience the number of patients has grown from 39 (9,9%) in 2006 to 156 (19.5%) in 2011. There were no severe complications. Umbilicitis was formed in 14 patients in periomphalic area, which didn’t require hospital treatment. From 2007 to 2010 in our hospital 102 (2.3%) patients, which were hospitalized with acute cholecystitis, were treated in a short term department.

Conclusions. Laparoscopic cholecystectomy in a “short term department” may be made in 20% of patients suffering from cholelitiasis. Laparoscopic cholecystectomy in “short term department” needs careful selection: non-presence of severe pathology (ASA I-II), absence of technical difficulties during operation, the ability of medical “support” after discharge. Laparoscopic cholecystectomy in “short term department” allows using surgical departments more effectively and requires the further study and development.