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Laparoscopic cholecystectomy (LC) has now become the “gold standard” treatment for symptomatic gallstone disease. Thanks to its advantages (i.e., smaller scars, reduced postoperative pain), patients enjoyed a shorter hospital stay and consequently, many healthcare providers have started to explore the feasibility of offering LC as a day-case procedure, and in 1990 some authors had already reported the first experiences of ambulatory surgery. Nowadays day-case LC (DLC) has been adopted with different rates and it is not fully accepted by all surgeons. The main question concerns whether the DLC might be feasible for all or just for selected cases. It is common opinion that DLC is indicated for selected cases and the selection may concern medical and logistic criteria. Some exclusion criteria may be considered advisable: common bile duct stones, acute cholecystitis, pancreatitis, patient’s age, and intraoperative complications. Some authors pointed out the importance of anesthesia and postoperative control of pain, nausea, and vomiting as strongly needed elements to allow patients’ early discharge. In conclusion DLC seems to be a safe and effective intervention in selected patients (with no or minimal systemic disease and within easy reach of the hospital) with symptomatic gallstones.

Classical outcome measures (mortality and complications) have to be considered to compare surgical treatments. As no significant differences between laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) were found in classical outcome measures, it is justified to consider health-related quality of life (HRQoL) an important secondary outcome measure. Indeed quality of life (QoL), symptoms resolution, duration of convalescence, and patient satisfaction and well-being are at least as important as the classical outcomes from a patient’s point of view. Instruments for measuring HRQoL may be disease specific or generic. We pointed out our attention to QoL considering these main topics: effectiveness of LC, comparison to OC, comparison to small-incision laparotomic cholecystectomy (SC), and impact of iatrogenic bile duct injury (BDI). In conclusion LC is an effective operation for the treatment of biliary disease-related symptoms in patients with cholelithiasis. LC improves QoL faster than OC, while long-term results are quite similar. When comparing QoL after LC and SC, the perception of health immediately after surgery is slightly better for patients treated with laparoscopic procedure, but the gain in QoL is small and of a very limited duration.