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Dr. Aali Ahmed Ejaz, Dr. Saad Ijaz, Dr. Muhammad Zeeshan
Goal: The objective of this study were to determine the safety and feasibility of Day case Laparoscopic Cholecystectomy, unplanned admission rate, identify reasons for unplanned admissions and re-admissions after discharge, and to explore how to improve the same day discharge rate. Project: A Retrospective descriptive study. Place and duration: In the Surgical department of POF Hospital Wah Cantt for one year duration from February 2019 to February 2020. Methodology: Patients with gallstones and biliary colic were selected at the clinic and ultrasound confirmed symptoms. Patients who hospitalized with cholecystitis, which improved after conservative treatment, were also considered for daily surgery after six weeks of discharge. Other criteria established for LC day care surgery were patients under 55 who received points I and II as an ASA fitness score, lived 50 km from the hospital, and were hospitalized in case of problems. During discharge, they were advised to go to the emergency room when they felt significant pain, vomiting or other ailments. Results: 62% of patients met the eligibility criteria, 224 patients and were considered sufficient for Day case LC. The most common reason for rejection was that the patient lived outside the specified area (20%). A total of 88.8% (199) of patients were discharged within eight hours after surgery. The reasons for discharge failure were abdominal drainage in 7 patients, vomiting in 6 patients, conversion to open surgery in 5 patients and late onset of surgery in 6 patients. One patient was admitted when SVT developed (paroxysmal supraventricular tachycardia. 5 patients (2.2%) after discharge and reported vomiting, one patient was admitted with benign hepatic collection, and one patient developed obstructive jaundice due to CBD stones. None of the patients had any surgical complications, and then he was discharged completely. Conclusions: Day case LC is safe, workable and potentially beneficial to the patient's healthcare system. We can improve our Day case LC and reduce the number of requests and re-requests by strictly following the instructions / protocols regarding Day Case LC and better cooperation with the anesthesiology department. Key words: Day case laparoscopic cholecystectomy, criteria for day case surgery, ASA I & II