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Published on: November 25, 2025
Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis
Alba Manuel-Vázquez1, Raquel Latorre-Fragua1, Carmen Ramiro-Pérez1
1Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia, Department of General and Digestive Surgery, University Hospital of Guadalajara, 19002 Guadalajara, Spain.
Insights
A 90-day readmission rate for cholecystectomy is 4.99%, higher than the 30-day rate. Non-biliary surgical complications were the most common cause of readmission after gallbladder surgery.
Area of Science:
- General Surgery
- Digestive System Diseases
Background:
- Cholecystectomy is a common surgical procedure for biliary pathology.
- Assessing post-operative complications, including readmissions, is crucial for patient outcomes and healthcare quality.
Purpose of the Study:
- To determine the incidence of hospital readmission within 90 days following cholecystectomy.
- To compare the 90-day readmission rate with the traditional 30-day metric.
Main Methods:
- Retrospective review of 1423 patients undergoing cholecystectomy at a university hospital.
- Inclusion criteria: readmission within 90 days for biliary pathology-related complications.
- Exclusion criteria: ambulatory surgery, combined procedures, active malignancy, scheduled unrelated readmissions.
Main Results:
- The 90-day readmission rate was 4.99% (71 of 1423 patients).
- Non-biliary surgical causes (46.48%), particularly intra-abdominal abscesses, were the most frequent readmission reason.
- Readmission rates increased from 3.51% at 30 days to 4.99% at 90 days, with nearly 50% occurring in the first week post-discharge.
Conclusions:
- A 30-day cutoff may underestimate the true incidence of cholecystectomy complications.
- Utilizing a 90-day period provides a more comprehensive assessment of post-surgical readmissions and complications.
- This extended timeframe aligns with current trends in surgical outcome measurement.
Aim:
To determine the incidence of readmission after cholecystectomy using 90 d as a time limit.
Methods:
We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies.
Results:
We analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of 4.99%. Sixty-four point seven nine percent occurred after elective surgery (cholelithiasis or vesicular polyps) and 35.21% after emergency surgery (acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d.
Conclusion:
The use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.
