Short-Stay Sleeve Gastrectomy, do we need more than 24 hours of hospital stay?

Tomas C Jakob, MD1, Patricio Cal, MD2, Luciano Deluca, MD1, Ezequiel Fernandez1. 1CRQO, 2Churruca Police Hospital

Background: Short stay procedures have gained popularity in many surgical sub-specialties. Main benefits are early discharge, minimal loss of productivity, costs reduction, and less risk of infections. This practices must not jeopardize patient’s security. Laparoscopic sleeve gastrectomy (LSG) has consolidated as a primary bariatric technique. Because of its quick post-operatory recovery it is a matter of discussion if patients benefit or not from hospitalization longer than 24 hours.

Objective: To prove the safety of short-stay surgery after LSG.

Design: Cross sectional, descriptive, retrospective.

Methods: We prospectively collected data about hospital stay, readmission rate, early and mid-term term major complications and reintervention rate on 2629 primary LSG performed between February 2007 and August 2014.

Results: From a total of 2629 patients, 2590 (98,52%) were discharged in the first 24 hours. Thirty-nine (1,48%) required longer hospital stay; 16 (0,61%) for vomiting, 23 (0,87%) for haemorrhage. Four patients (0,15%) were readmitted for digestive intolerance between day 2 and 4. A total of 26 leaks (0,99%) occurred between postoperative day 5 and 41; 5 abdominal collections (0,19%) non related neither to fistulas nor bleeding occurred between day 6 and 16. From 33 (1,25%) haemorrhagic complications, 5 (0,19%) required reoperation in the first 24 hours and 7 (0,27%) percutaneous drainage after 7th postoperative day. No major complications occurred between days 1 and 4.

Conclusions: Evidence suggests that hospital stay for more than 24 hours after LSG is unnecessary in patients with no persistent vomiting or signs of bleeding or leaks. Major complications presented either within the first 24 hours or after the fourth postoperative day.

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