日间腹腔镜胆囊切除术推广模式的探讨OA

Objective:To explore the promotion model of day case laparoscopic cholecystectomy(DCLC)based on single-center clinical practice,and to preliminarily verify its safety and efficacy.Methods:A retrospective analysis was performed on clinical data of 159 consecutive patients who underwent laparoscopic cholecystectomy from Jan.1,2025 to Dec.31,2025.All patients followed the enhanced recovery after surgery model and were automatically enrolled in DCLC management.The termination of DCLC was deter-mined based on postoperative recovery conditions.Results:Finally,118 patients who met the day case criteria were included in the DCLC group,and 41 patients who withdrew from DCLC were included in the non-DCLC group.The success rate of DCLC was 74.21%.There were no statistically significant differences in gender,BMI,or preoperative ASA classification between the two groups(P>0.05).The age of patients in the non-DCLC group was older than that in the DCLC group(P=0.032).The DCLC group had shorter operative time[65(55,75)min vs.75(55,106)min,P=0.001],postoperative flatus time[(9.76±1.78)h vs.(15.48±2.89)h,P<0.001],abdominal drainage tube removal time[(15.26±3.89)h vs.(24.18±4.63)h,P<0.001]and hospital stay[(28.1±10.3)h vs.(72.5±48.6)h,P<0.001],and lower postoperative pain score[(1.12±0.32)vs.(2.03±0.67),P<0.001],white blood cell,ALT,GGT and hospitalization expenses compared with the non-DCLC group.No severe complications occurred in either group.Con-clusions:The core measures of enhanced recovery after surgery are applicable to DCLC.The DCLC model without additional inclusion criteria is safe and feasible,which can expand the beneficiary population,effectively shorten hospital stay,reduce medical costs,and does not increase the risk of severe complications.