OUTPATIENT LAPARASCOPIC SURGERY TRIAL (OLST)

门诊腹腔镜手术试验 (OLST)

• 批准号: 6245476
• 负责人: LEE A FLEISHER
• 金额: $ 2.23万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-03-05 至 1997-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6245476
• 关键词: cholecystectomy; clinical research; clinical trials; endoscopy; health care cost /financing; human subject; outpatient care; postoperative complications

A total of 99 patients were enrolled into the now completed study. Two of the patients were converted from laparoscopic to an open cholecystectomy due to failure to obtain good surgical exposure, and were therefore excluded from the study. The laparoscopic procedure in a third patient was technically difficult and required placement of a closed suction drain in the subhepatic space at the end of the procedure. This patient was not eligible for discharge home the day of surgery and was also excluded from the study. All 96 patients had an uneventful intraoperative course. There were no postoperative complications other than nausea and vomiting. Eleven (11/96 or 12%) patients experienced postoperative nausea and vomiting requiring pharmacologic therapy. Of the 11 patients with PONV requiring treatment, 3 required an additional day of hospitalization due to the inability to tolerate oral intake. The average charges associated with an outpatient procedure were $2131. The average charge for a 24 hour inpatient procedure during the same time period was $3878, yielding an average net potential savings of $1747. Our study suggests that laparoscopic cholecystectomy can be performed safely and more cost-effectively on an outpatient basis and has led to a change in management. We are currently following patients prospectively who are discharged home the same day as the planned surgery.

共有 99 名患者参加了现已完成的研究。两个 患者从腹腔镜胆囊切除术转为开腹胆囊切除术 由于未能获得良好的手术暴露，因此 排除在研究之外。 第三位患者的腹腔镜手术 技术上很困难，需要放置一个封闭的抽吸排水管 手术结束时位于肝下空间。 这位患者是 手术当天不符合出院回家资格，也被排除在外 从研究中。 所有 96 名患者的术中过程都很顺利。 术后除恶心、呕吐外无其他并发症。 11 名（11/96 或 12%）患者经历术后恶心和 呕吐需要药物治疗。 11 名 PONV 患者中 需要治疗，其中 3 人需要额外住院一天 无法耐受口服摄入。相关平均费用 门诊手术费用为 2131 美元。 24小时平均电量 同期住院手术费用为 3878 美元， 平均净潜在节省额为 1747 美元。 我们的研究表明可以进行腹腔镜胆囊切除术 在门诊治疗中安全且更具成本效益，并已导致 管理层的变化。 我们目前正在前瞻性地跟踪患者 在计划手术当天出院回家的人。