Prospective studies that compared the effects of ambulatory laparoscopic with in-patient laparoscopic cholecystectomy on complications, admissions, re-admissions and patient satisfaction were eligible for inclusion. Studies had to use well-defined criteria to select patients for ambulatory care and report quality of life data at 24 hours and one week. Studies that assessed other outcomes such as nausea and vomiting, analgesia and anaesthetic outcomes were excluded.
In the included studies, mean age was 42 years for ambulatory patients and 47 years for in-patients. All but one of the studies were in patients graded I or II using American Society of Anesthesiologists criteria; information was not provided in the remaining study. Studies used a standard protocol; patients who did not fulfill criteria were admitted overnight. Surgery was performed by consultants or trainees, where reported. In about half of the studies, cholangiograms were routinely or selectively performed; cholangiograms were not done in other studies. Most studies reported use of prophylactic analgaesia and about half of the studies used preoperative or postoperative local analgesia. Studies were conducted in Europe, USA and Australia.
Two reviewers independently screened reference lists, but no other details of the study selection process were reported.