Fast-Track Nonelective Laparoscopic Cholecystectomy is Safe and Feasible

Area of Science:

• Surgical Outcomes
• Gastroenterology
• Health Services Research

Background:

• Elective laparoscopic cholecystectomy (LC) has established fast-track discharge protocols.
• Safety data for fast-tracking nonelective LC is currently lacking.

Purpose of the Study:

• To evaluate the safety and feasibility of fast-tracking patients undergoing nonelective LC.
• To compare outcomes between elective LC and fast-track nonelective LC (FTLC).

Main Methods:

• Retrospective cohort review of 661 LC patients.
• Comparison of elective LC (ELC) vs. FTLC (nonelective LC with length of stay <36 hours).
• Primary outcome: 30-day readmission; Secondary outcomes: 30-day ED return, retained stone, bile leak, wound infection.

Main Results:

• FTLC included 121 (25%) of 476 nonelective LC cases.
• No significant difference in 30-day readmission rates between ELC (3%) and FTLC (3%).
• Similar rates of emergency department return, retained stones, bile leaks, and wound infections across groups.

Conclusions:

• Fast-track nonelective LC is safe and feasible in select patients.
• Postoperative complication rates are comparable to elective LC.
• Further research is needed to identify preoperative predictors for FTLC suitability.