Psychological and sociodemographic factors for delayed patient discharge after daycare laparoscopic cholecystectomy.
Keywords:Day Care Surgery, Gall Bladder, Laparoscopic Cholecystectomy, Pain, Postoperative Complication
Objective: To estimate the psychological and sociodemographic correlates of delayed discharge of patients undergoing Elective Laparoscopic Cholecystectomy. Study Design: Retrospective Cross-sectional Descriptive study. Setting: Department of Surgery, Fauji Foundation Hospital. Period: July 2019 and June 2022. Material & Methods: The study comprised reviewing medical records of 160 patients who underwent daycare cholecystectomy. It was noticed from patients’ medical records that patients were carefully selected for daycare surgery. Patients with comorbidities, previous upper intra-abdominal surgery, ultrasound findings of thickened gallbladder wall > 5mm were not offered day care surgery. For data collection a Performa was designed based on literature review. To assess psychological state, we applied Hospital anxiety and depression scale in Urdu. Descriptive statistics were calculated for the sociodemographic variables, mean and standard deviation was found for continuous variables and frequency percentages for categorical variables. Results: One hundred and thirty-one 131 (81.8 percent) of the 160 cholecystectomies could be sent home within 24 hours, whereas 29 (18 percent) required a lengthier hospital stay. One hundred and thirty-one 131 (81.8 percent) of the 160 cholecystectomies could be sent home within 24 hours, whereas 29 (18 percent) required a lengthier hospital stay. In LS group, the postoperative stay range was 2 –19. Observation of postoperative fever (n = 3), surgery-related causes postoperative pain (n= 6), delayed oral diet = 1, retained abdominal drain = 4, and postoperative complications (n= 3). Bowel injury (n = 2) and septicemia (n = 1) were serious postoperative consequences resulting in more prolonged hospital stay. PONV (n = 2), medical causes (n = 3), and patient preference (n = 7) were among the reasons for the prolonged hospital stay. Conclusion: While our study has a few limitations; it is a retrospective review with nonrandomized patient selection and a smaller sample size, we have established safety of day case laparoscopic cholecystectomy in select group of patients. Patients’ personal satisfaction was the most common reason for their overnight admission after day case LC which was because of number of sociodemographic factors.
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