Outpatient Laparoscopic Cholecystectomy: Experience of a Nonovernight Surgicenter

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Abstract
From April 1994 to September 1998, a total of 66 laparoscopic cholecystectomies were performed at the same-day freestanding Surgicenter of the Yankton Medical Clinic. All patients (ages 15 to 62 years; 91% women) were discharged the same day, and no patient required hospitalization despite two conversions to open cholecystectomy. Cholangiofluoroscopies were completed in 70% of the patients. Pathologic evaluation showed chronic cholecystitis in all patients except one, who also had acute disease. No patient was lost to follow-up, and 98% responded that they "would do it again." These results confirm the safety of laparoscopic cholecystectomy in selected patients in a low- and controlled-cost environment of a freestanding surgical facility. Interestingly, Medicare does not allow facility reimbursement for cholecystectomy in any nonovernight outpatient surgery center in South Dakota.

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