Day-case laparoscopic cholecystectomy seems to be safe and can be done successfully in more than three-quarters of selected patients

Although day-case laparoscopic cholecystectomy (removal of gallbladder through keyhole surgery) can save bed costs, its safety has to be established. In this systematic review of randomised clinical trials, we included five trials with 429 patients randomised to day-case group (215 patients) and to overnight stay group (214 patients). Four of the five trials were of low risk of bias. The trials recruited 49% of patients undergoing cholecystectomy (removal of gallbladder). The selection criteria varied, but most included only patients without other diseases. The patients were living in easy reach of the hospital and with a responsible adult to take care of them. 81% of day-case patients were discharged on the day of surgery. The drop-out rate after randomisation varied between 6.5% and 12.7%. There was no significant difference between day-case and overnight stay group as regards to complications, prolongation of hospital stay, re-admission rates, pain, quality of life, patient satisfaction, and return to normal activity and work. Day-case elective laparoscopic cholecystectomy seems to be safe and effective treatment in selected patients (with no or minimal systemic disease and within easy reach of the hospital) with symptomatic gallstones. Because of the decreased hospital stay, it is likely to save costs.