Characteristics of outpatient and hospital laparoscopic cholecystectomy, Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras, 2012-2013

Abstract

Background: Laparoscopic outpatient cholecystectomy (LOC) is the procedure where time between patient admission and discharge is <12 hours. This procedure was implemented at the Hospital Especialidades (HE) of the Instituto Hondureño de Seguridad Social (IHSS), Tegucigalpa, since 2007. Objective: To determine the characteristics of CLA and laparoscopic hospitalized cholecystectomy (LHC), IHSS, 2012-2013. Methods: Descriptive study in patients seen in Outpatient Surgery Unit and HE IHSS, January 2012-January 2013. We registered sociodemographic and clinical characteristics from clinical charts randomly selected. Costbenefit was estimated based on cost per procedure, days of hospitalization and disability. Results are presented as frequency and percentage, odds ratio (OR), 95% confidence intervals and p value <0.05. Results: 100 patients in each group were analyzed. Factors associated to LOC included age ≤50 years old (3.8, 2.1<OR<7, p= 0.0001), evolution <3 months (2.0, 1.1<OR<3.6, p=0.02), previous pain episodes (2.2, 1.0<OR< 5.1, p=0.05). Presence of co-morbidity was associated to LHC (0.5 0.2<OR<0.9, p=0.02). There was no statistic difference in regard to sex and post-surgical procedure complications. This study estimated average cost USD 800.00 and USD 1,500.00 for LOC and LHC, respectively. Discussion: Both groups were different in terms of age, disease evolution, previous pain episodes and co-morbidity. It is necessary to establish a protocol for LOC and LHC, recommending LOC to patients accordingly to a clinical profile. LOC is a safe procedure that reduced 50% of the costs of hospitalization, representing an alternative option for Honduras public hospitals.