OBJECTIVE: Analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance. PATIENTS AND METHOD: Eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service) from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients. RESULTS: Group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017), inability to tolerate oral diet (p = 0.002), and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003). CONCLUSIONS: Outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.

Ambulatory Surgical Procedures↗

PubMed2003

[Endoscopical treatment with biological glue of esophageal fistula after surgery of Boerhaave syndrome].

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Adhesives↗

PubMed2003

[Frantź s tumor in a 57 years old woman].

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Cystadenoma↗

PubMedDate not supplied

[Adrenal gland hematoma due to rupture of myelolipoma. A case report].

The myelolipoma is a benign tumour of the adrenal cortex, non functioning and normally asymptomatic, which can be diagnosed by chance in imaging test. Rupture and bleeding of the myelolipoma is an infrequent complication, which can conclude with the formation of a haematoma or, less usually, result in a massive retroperitoneal haemorrhage. The compression of adjacent structures by retroperitoneal haematomas with adrenal origin is a possible but not frequent eventuality. Indications for surgery of haematoma retroperitoneal continue to be, nowadays, a difficult and controversial decision, because the problem is normally resolved with conservative treatment and a watchful approach. We are presented with a 69 year old male who came to casualty with abdominal pain of 7 days duration, whose origin coincided with a light blow. The image test revealed the existence of a retroperitoneal haematoma with adrenal gland origin of 16 cm, with active bleeding, which was displaced and compressed the cava vein. We have only found one case, in the literature, of compression of the cava vein coused by adrenal gland haematoma. In the case under our observation, urgent surgery was needed.

Adrenal Gland Diseases↗