摘要:

ObjectiveTo assess whether sound economic reasons exist for the wider introduction of laparoscopic cholecystectomy in Australia.DesignA retrospective survey of patients who underwent laparoscopic cholecystectomy. We compared time of hospital stay and time off work after laparoscopic cholecystectomy with data for open cholecystectomy.Patients and settingSeventeen participating surgeons in four Australian States allowed access to patients treated between May 1990 and November 1991 (1254 patients in all).Main outcome measuresPatient acceptability of the procedure, average length of postoperative in‐hospital stay, and the savings associated with earlier return to work compared with open cholecystectomy.ResultsAlmost 90% of patients (1127) replied and 1088 responses were considered appropriate for analysis. Serious complications were rare; 96% of patients thought the technique was successful. The mean length of in‐hospital stay was 2.6 days (range, 1–120), compared with a mean of 8.7 days for open cholecystectomy. Among working patients, the mean time to return to work was 11.6 days (range, 10.7–13.1), an estimated 27 days sooner than after open cholecystectomy. Extrapolating from these results, replacing 95% of open cholecystectomies with laparoscopic procedures would save 133 285 hospital bed‐days and 500 000 work‐days each year.ConclusionLaparoscopic cholecystectomy is safe and effective. Its wider use in Australia would result in savings to both the individual and the national economy.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138550.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138552.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138553.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138554.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138555.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138556.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Sleep complaints are common in the elderly, and are often related to physiological changes with ageing, or secondary to illness and drug therapy. Primary sleep disorders, such as sleep apnoea and movement disorders, are also common. Management should be specific to the problem. Attention to underlying factors and sleep hygiene, as well as reassurance and education about age‐related sleep changes, will often be sufficient. Hypnotics, which usually offer only temporary symptomatic relief, may be counterproductive, and should be prescribed only in the short term, except in limited specific cases. Short‐acting benzodiazepines (e.g., temazepam or oxazepam), or possibly zopiclone, are currently the drugs of choice.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138557.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138559.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138562.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138563.x

出版商:Wiley    

年代:1995

数据来源: WILEY