Feasibility and safety study of daytime laparoscopic cholecystectomy in high-altitude areas_West China Medical Journal

Authors：

LÜ Meng ,  SU Wei , DING Xia , MA Rong , GAO Junlin

Department of Hepatobiliary Pancreatic Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, P. R. China;

Corresponding author：

SU Wei, Email: 37127496@qq.com

Keywords：

Daytime surgery; laparoscopic cholecystectomy; high-altitude area

DOI：

10.7507/1002-0179.202412282

Video：

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Objective To explore the feasibility and safety of daytime laparoscopic cholecystectomy in high-altitude areas. Methods Clinical data of patients with gallstones undergoing laparoscopic cholecystectomy admitted to Qinghai Red Cross Hospital between January and December 2023 were retrospectively collected. Patients were divided into daytime surgery group and routine surgery group according to their hospitalization method. The gender, age, ethnicity, American Society of Anesthesiologists classification, comorbidities, postoperative pain, postoperative indwelling drainage tube, postoperative nausea and vomiting, overall satisfaction, length of hospital stay, and hospitalization costs of the two groups of patients were compared. Results A total of 95 patients who underwent daytime surgery and 186 patients who underwent routine surgery were included. There was no statistically significant difference in gender, age, comorbidities, or American Society of Anesthesiologists classification between the two groups of patients (P>0.05). The proportion of Han patients in the daytime surgery group was higher than that in the routine surgery group (69.5% vs. 34.4%, P<0.05). All patients successfully completed the surgery without any serious complication. There was no statistically significant difference in postoperative indwelling drainage tube, postoperative nausea and vomiting, postoperative pain, or overall satisfaction between the two groups of patients (P>0.05). The length of hospital stay [(1.03±0.17) vs. (5.30±1.53) d] and hospitalization expenses [(8104.97±660.65) vs. (8947.82±746.19) yuan] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). Conclusion Daytime laparoscopic cholecystectomy is safe and feasible for patients in high-altitude areas without comorbidities or with stable control of comorbidities, and is beneficial for reducing the medical burden on patients.

Citation： LÜ Meng, SU Wei, DING Xia, MA Rong, GAO Junlin. Feasibility and safety study of daytime laparoscopic cholecystectomy in high-altitude areas. West China Medical Journal, 2025, 40(2): 194-197. doi: 10.7507/1002-0179.202412282 Copy

1.	刘厚宝, 倪小健, 沈盛, 等. 胆囊良性疾病的治疗现状与思考. 中华消化外科杂志, 2020, 19(8): 813-819.
2.	沈艳玲, 通耀威, 张晓倩. 日间与住院腹腔镜胆囊切除术疗效的 Meta 分析. 腹腔镜外科杂志, 2022, 27(6): 439-446.
3.	刘力玮, 郑亚民, 刘东斌, 等. 日间腹腔镜胆囊切除术的可行性分析. 腹腔镜外科杂志, 2021, 26(5): 359-362.
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6.	毕琪, 骆华杰. 1997-2017 年基于 CNKI 数据库的日间手术文献计量分析. 中国医院, 2019, 23(1): 34-37.
7.	杨波, 侯永志, 王翔飞, 等. 西藏高原地区胆囊结石危险因素分析. 临床肝胆病杂志, 2018, 34(4): 789-794.
8.	张中文. 胆石病的流行病学和危险因素. 外科理论与实践, 2011, 16(4): 408-412.
9.	吕砚青, 展翔, 段希斌. “集中管理+分散收治”日间手术管理模式经验分享. 华西医学, 2024, 39(2): 279-282.
10.	中国研究型医院学会微创外科学专业委员会, 胡三元, 刘荣. 日间腹腔镜胆囊切除术专家共识. 临床肝胆病杂志, 2023, 39(11): 2550-2557.
11.	国际日间手术学会, 中国日间手术合作联盟. 日间手术发展与实践. 北京: 人民卫生出版社, 2016: 1-2.
12.	Yang YF, Li BF, Xiao Y. Research progress on quality control of daytime laparoscopic cholecystectomy. J Laparosc Surg, 2020, 25(10): 796-798, 800.
13.	青海国土经略. 青海省发布《青海省第一次全国地理国情普查公报》. 青海国土经略, 2017(5): 92-93.
14.	张英. 高原环境血红蛋白变化的若干研究. 高原医学杂志, 2008, 18(2): 62-64.
15.	于均涛, 丹珠永吉, 徐妮, 等. 海南州贵德县 1612 名健康成人静脉血红细胞、血红蛋白、血小板计数参考值范围及影响因素调查. 职业与健康, 2020, 36(11): 1519-1521, 1526.
16.	Meillat H, Brun C, Zemmour C, et al. Laparoscopy is not enough: full ERAS compliance is the key to improvement of short-term outcomes after colectomy for cancer. Surg Endosc, 2020, 34(5): 2067-2075.
17.	王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
18.	Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
19.	沈火剑, 李可为, 季福, 等. 日间腹腔镜胆囊切除术的临床应用分析. 肝胆胰外科杂志, 2011, 23(1): 43-45.
20.	刘玲, 顾殿华, 陶国全. 腹腔镜胆囊切除术后胆漏的原因分析和防治. 东南大学学报(医学版), 2008, 27(2): 99-101.
21.	李玉民, 毛杰. 腹腔引流在外科感染防治中的合理应用. 中国实用外科杂志, 2016, 36(2): 143-146.
22.	赵森峰, 豆松萌, 刘博, 等. 腹腔引流对日间腹腔镜胆囊切除术患者的临床疗效分析. 解放军医学院学报, 2018, 39(8): 685-687.
23.	Lee C, Chung JY, Lee M. Sex-related differences in the efficacy of dexamethasone pretreatment for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a randomized controlled study. Turk J Med Sci, 2017, 47(4): 1282-1286.
24.	刘怡, 罗贞, 唐雪姣, 等. 集束化策略对日间腹腔镜胆囊手术患者术后恶心呕吐的影响. 华西医学, 2024, 39(2): 195-199.

1. 刘厚宝, 倪小健, 沈盛, 等. 胆囊良性疾病的治疗现状与思考. 中华消化外科杂志, 2020, 19(8): 813-819.
2. 沈艳玲, 通耀威, 张晓倩. 日间与住院腹腔镜胆囊切除术疗效的 Meta 分析. 腹腔镜外科杂志, 2022, 27(6): 439-446.
3. 刘力玮, 郑亚民, 刘东斌, 等. 日间腹腔镜胆囊切除术的可行性分析. 腹腔镜外科杂志, 2021, 26(5): 359-362.
4. 中华医学会外科学分会, 中华医学会麻醉学分会. 加速康复外科中国专家共识及路径管理指南(2018 版). 中国实用外科杂志, 2018, 38(1): 1-20.
5. 中华医学会外科学分会, 中华医学会麻醉学分会. 加速康复外科中国专家共识暨路径管理指南(2018). 中华麻醉学杂志, 2018, 38(1): 8-13.
6. 毕琪, 骆华杰. 1997-2017 年基于 CNKI 数据库的日间手术文献计量分析. 中国医院, 2019, 23(1): 34-37.
7. 杨波, 侯永志, 王翔飞, 等. 西藏高原地区胆囊结石危险因素分析. 临床肝胆病杂志, 2018, 34(4): 789-794.
8. 张中文. 胆石病的流行病学和危险因素. 外科理论与实践, 2011, 16(4): 408-412.
9. 吕砚青, 展翔, 段希斌. “集中管理+分散收治”日间手术管理模式经验分享. 华西医学, 2024, 39(2): 279-282.
10. 中国研究型医院学会微创外科学专业委员会, 胡三元, 刘荣. 日间腹腔镜胆囊切除术专家共识. 临床肝胆病杂志, 2023, 39(11): 2550-2557.
11. 国际日间手术学会, 中国日间手术合作联盟. 日间手术发展与实践. 北京: 人民卫生出版社, 2016: 1-2.
12. Yang YF, Li BF, Xiao Y. Research progress on quality control of daytime laparoscopic cholecystectomy. J Laparosc Surg, 2020, 25(10): 796-798, 800.
13. 青海国土经略. 青海省发布《青海省第一次全国地理国情普查公报》. 青海国土经略, 2017(5): 92-93.
14. 张英. 高原环境血红蛋白变化的若干研究. 高原医学杂志, 2008, 18(2): 62-64.
15. 于均涛, 丹珠永吉, 徐妮, 等. 海南州贵德县 1612 名健康成人静脉血红细胞、血红蛋白、血小板计数参考值范围及影响因素调查. 职业与健康, 2020, 36(11): 1519-1521, 1526.
16. Meillat H, Brun C, Zemmour C, et al. Laparoscopy is not enough: full ERAS compliance is the key to improvement of short-term outcomes after colectomy for cancer. Surg Endosc, 2020, 34(5): 2067-2075.
17. 王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
18. Cao J, Liu B, Li X, et al. Analysis of delayed discharge after day-surgery laparoscopic cholecystectomy. Int J Surg, 2017, 40: 33-37.
19. 沈火剑, 李可为, 季福, 等. 日间腹腔镜胆囊切除术的临床应用分析. 肝胆胰外科杂志, 2011, 23(1): 43-45.
20. 刘玲, 顾殿华, 陶国全. 腹腔镜胆囊切除术后胆漏的原因分析和防治. 东南大学学报(医学版), 2008, 27(2): 99-101.
21. 李玉民, 毛杰. 腹腔引流在外科感染防治中的合理应用. 中国实用外科杂志, 2016, 36(2): 143-146.
22. 赵森峰, 豆松萌, 刘博, 等. 腹腔引流对日间腹腔镜胆囊切除术患者的临床疗效分析. 解放军医学院学报, 2018, 39(8): 685-687.
23. Lee C, Chung JY, Lee M. Sex-related differences in the efficacy of dexamethasone pretreatment for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a randomized controlled study. Turk J Med Sci, 2017, 47(4): 1282-1286.
24. 刘怡, 罗贞, 唐雪姣, 等. 集束化策略对日间腹腔镜胆囊手术患者术后恶心呕吐的影响. 华西医学, 2024, 39(2): 195-199.

West China Medical Journal

Feasibility and safety study of daytime laparoscopic cholecystectomy in high-altitude areas

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