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Original Article
 
Outpatient laparoscopic cholecystectomy: Experience of a university group practice in a developing country
Anthony Relucio Perez1, Krista Angeli Delos Santos1
1Associate Professor, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of the Philippines Manila, Philippine General Hospital and UP College of Medicine, Manila, Philippines.

Article ID: 100059IJHPDAP2016
doi:10.5348/ijhpd-2016-58-OA-15

Address correspondence to:
Anthony Relucio Perez
UP-PGH Medical Center
Taft Avenue, Manila
Philippines, 1000

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How to cite this article
Perez AR, Santos KAD. Outpatient laparoscopic cholecystectomy: Experience of a university group practice in a developing country. Int J Hepatobiliary Pancreat Dis 2016;6:81–88.


Abstract
Aims: In developed countries, efforts to improve outcome and minimize costs prompted the performance of laparoscopic cholecystectomy as an outpatient procedure. In the Philippines and in most developing countries, most laparoscopic cholecystectomies are still performed on admitted patients who are discharged one or more days after the surgery. No local experience has been published in the Philippines demonstrating the safety and feasibility of outpatient laparoscopic cholecystectomy.
Materials and Methods: This study is a retrospective study investigating the outcome of outpatient performed laparoscopic cholecystectomy in the University of the Philippines, Philippine General Hospital Faculty Medical Arts Building (UP-PGH FMAB), an ambulatory surgical facility within UP-PGH. The patients were admitted to the ambulatory facility on the day of surgery, underwent laparoscopic cholecystectomy under general anesthesia and discharged on the same day.
Results: From June 2012 to June 2016, 122 patients underwent laparoscopic cholecystectomy at the UP-PGH Faculty medical arts building. There were 80 women (85%) and 42 men (15%) with a mean age of 46 years. The mean operating time was 58 minutes. The unplanned admission rate was 2.4% (two patients), one for conversion to open and two for unrelieved postoperative nausea and vomiting.
Conclusion: Outpatient laparoscopic cholecystectomy is safe and technically feasible even in developing countries. It has potential for much economical and social benefit when employed judiciously. Prospective, randomized trials must be conducted in the local setting to refine technique, standardize patient selection and address system deficiencies to allow safe performance of outpatient laparoscopy in the Philippines.

Keywords: Day surgery, Developing country, Laparoscopic cholecystectomy, Outpatient laparoscopy


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Author Contributions:
Anthony Relucio Perez – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Krista Angeli Delos Santos – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Anthony Relucio Perez et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Anthony R. Perez is an Associate Professor of Surgery at the University of the Philippines, Manila College of Medicine and Attending Surgeon at the Philippine General Hospital. He is the Vice Chair for Training of the Department of Surgery and Chief of the Division of Endosurgery. He earned undergraduate and medical degrees from the University of the Philippines and has a Masters Degree in Hospital Administration from the same University. He completed residency training in General Surgery in the Philippine General Hospital and did a Visiting Fellowship at the Massachusetts General Hospital. Research interests include Hepatobiliary and Pancreatic Surgery, Hernia and Minimally Invasive Surgery.



Krista Angeli Delos Santos is an Associate Professor, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of the Philippines Manila, Philippine General Hospital and UP College of Medicine, Manila, Philippines.