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Day case laparoscopic cholecystectomy: reducing the admission rate
Jacob A Akoh1, Will A Watson, Thomas P Bourne
1Department of Surgery, Level 04 Derriford Hospital, Plymouth PL6 8DH, United Kingdom. Jacob.akoh@phnt.swest.nhs.uk
International Journal of Surgery (London, England)
|October 5, 2010
Summary
Day case laparoscopic cholecystectomy (DCLC) shows a 69% same-day discharge rate. Avoiding drains and careful patient selection can reduce unplanned admissions for DCLC, improving efficiency.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Day case laparoscopic cholecystectomy (DCLC) is increasingly adopted for economic and efficiency benefits.
- Assessing unplanned admission rates and reasons is crucial for optimizing DCLC protocols.
Purpose of the Study:
- To determine the unplanned admission rate following DCLC.
- To identify key factors contributing to unplanned admissions and re-admissions.
- To explore strategies for enhancing same-day discharge rates in DCLC patients.
Main Methods:
- A retrospective review of 258 patients undergoing DCLC between April 2008 and March 2009.
- Analysis of patient data to identify predictors of unplanned admission.
- Statistical analysis using SPSS for Windows.
Main Results:
- 69% of patients were discharged on the same day after DCLC.
- Higher admission rates were observed for patients with biliary colic (29.4%), cholecystitis (37.7%), and a history of jaundice (75%).
- Primary reasons for admission included drain insertion and late operation start times.
Conclusions:
- Optimizing patient selection, surgical scheduling, and avoiding drain use can significantly reduce unplanned admissions post-DCLC.
- Surgical trainee experience did not adversely affect patient outcomes despite longer operation times.
