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.	劉厚寶, 倪小健, 沈盛, 等. 膽囊良性疾病的治療現狀與思考. 中華消化外科雜志, 2020, 19(8): 813-819.
2.	沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的 Meta 分析. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
3.	劉力瑋, 鄭亞民, 劉東斌, 等. 日間腹腔鏡膽囊切除術的可行性分析. 腹腔鏡外科雜志, 2021, 26(5): 359-362.
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7.	楊波, 侯永志, 王翔飛, 等. 西藏高原地區膽囊結石危險因素分析. 臨床肝膽病雜志, 2018, 34(4): 789-794.
8.	張中文. 膽石病的流行病學和危險因素. 外科理論與實踐, 2011, 16(4): 408-412.
9.	呂硯青, 展翔, 段希斌. “集中管理+分散收治”日間手術管理模式經驗分享. 華西醫學, 2024, 39(2): 279-282.
10.	中國研究型醫院學會微創外科學專業委員會, 胡三元, 劉榮. 日間腹腔鏡膽囊切除術專家共識. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
11.	國際日間手術學會, 中國日間手術合作聯盟. 日間手術發展與實踐. 北京: 人民衛生出版社, 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.	青海國土經略. 青海省發布《青海省第一次全國地理國情普查公報》. 青海國土經略, 2017(5): 92-93.
14.	張英. 高原環境血紅蛋白變化的若干研究. 高原醫學雜志, 2008, 18(2): 62-64.
15.	于均濤, 丹珠永吉, 徐妮, 等. 海南州貴德縣 1612 名健康成人靜脈血紅細胞、血紅蛋白、血小板計數參考值范圍及影響因素調查. 職業與健康, 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.	王輝, 王堅. 加速康復外科理念指導下的日間腹腔鏡膽囊切除術 1400 例分析. 肝膽胰外科雜志, 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.	沈火劍, 李可為, 季福, 等. 日間腹腔鏡膽囊切除術的臨床應用分析. 肝膽胰外科雜志, 2011, 23(1): 43-45.
20.	劉玲, 顧殿華, 陶國全. 腹腔鏡膽囊切除術后膽漏的原因分析和防治. 東南大學學報(醫學版), 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應用. 中國實用外科雜志, 2016, 36(2): 143-146.
22.	趙森峰, 豆松萌, 劉博, 等. 腹腔引流對日間腹腔鏡膽囊切除術患者的臨床療效分析. 解放軍醫學院學報, 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.	劉怡, 羅貞, 唐雪姣, 等. 集束化策略對日間腹腔鏡膽囊手術患者術后惡心嘔吐的影響. 華西醫學, 2024, 39(2): 195-199.

1. 劉厚寶, 倪小健, 沈盛, 等. 膽囊良性疾病的治療現狀與思考. 中華消化外科雜志, 2020, 19(8): 813-819.
2. 沈艷玲, 通耀威, 張曉倩. 日間與住院腹腔鏡膽囊切除術療效的 Meta 分析. 腹腔鏡外科雜志, 2022, 27(6): 439-446.
3. 劉力瑋, 鄭亞民, 劉東斌, 等. 日間腹腔鏡膽囊切除術的可行性分析. 腹腔鏡外科雜志, 2021, 26(5): 359-362.
4. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018 版). 中國實用外科雜志, 2018, 38(1): 1-20.
5. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識暨路徑管理指南(2018). 中華麻醉學雜志, 2018, 38(1): 8-13.
6. 畢琪, 駱華杰. 1997-2017 年基于 CNKI 數據庫的日間手術文獻計量分析. 中國醫院, 2019, 23(1): 34-37.
7. 楊波, 侯永志, 王翔飛, 等. 西藏高原地區膽囊結石危險因素分析. 臨床肝膽病雜志, 2018, 34(4): 789-794.
8. 張中文. 膽石病的流行病學和危險因素. 外科理論與實踐, 2011, 16(4): 408-412.
9. 呂硯青, 展翔, 段希斌. “集中管理+分散收治”日間手術管理模式經驗分享. 華西醫學, 2024, 39(2): 279-282.
10. 中國研究型醫院學會微創外科學專業委員會, 胡三元, 劉榮. 日間腹腔鏡膽囊切除術專家共識. 臨床肝膽病雜志, 2023, 39(11): 2550-2557.
11. 國際日間手術學會, 中國日間手術合作聯盟. 日間手術發展與實踐. 北京: 人民衛生出版社, 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. 青海國土經略. 青海省發布《青海省第一次全國地理國情普查公報》. 青海國土經略, 2017(5): 92-93.
14. 張英. 高原環境血紅蛋白變化的若干研究. 高原醫學雜志, 2008, 18(2): 62-64.
15. 于均濤, 丹珠永吉, 徐妮, 等. 海南州貴德縣 1612 名健康成人靜脈血紅細胞、血紅蛋白、血小板計數參考值范圍及影響因素調查. 職業與健康, 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. 王輝, 王堅. 加速康復外科理念指導下的日間腹腔鏡膽囊切除術 1400 例分析. 肝膽胰外科雜志, 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. 沈火劍, 李可為, 季福, 等. 日間腹腔鏡膽囊切除術的臨床應用分析. 肝膽胰外科雜志, 2011, 23(1): 43-45.
20. 劉玲, 顧殿華, 陶國全. 腹腔鏡膽囊切除術后膽漏的原因分析和防治. 東南大學學報(醫學版), 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應用. 中國實用外科雜志, 2016, 36(2): 143-146.
22. 趙森峰, 豆松萌, 劉博, 等. 腹腔引流對日間腹腔鏡膽囊切除術患者的臨床療效分析. 解放軍醫學院學報, 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. 劉怡, 羅貞, 唐雪姣, 等. 集束化策略對日間腹腔鏡膽囊手術患者術后惡心嘔吐的影響. 華西醫學, 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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