True Day Case Laparoscopic Cholecystectomy in a Dgh: Outcomes and Factors Leading to Overnight Admisssion

Introduction:

A prospective audit was undertaken of true day case laparoscopic cholecystectomies performed by a single surgeon in a DGH. The audit aims primarily to ascertain the outcome of the operation and patients’ satisfaction with the experience. Data was analysed to identify factors that led to overnight admissions.

Methods:

Data collected using audit proformas. Collected data included intra- and post-operative analgesics and antiemetics and a phone survey of patients on the day after the operation. We obtained postoperative complications and admissions data from patients’ records.

Results:

22 patients were admitted for day case laparoscopic cholecystectomy between June 07 and May 08. 17 (77%) were discharged on the same day. 5 patients (23%) were admitted, of these: 2 (40%) were discharged within 24h and 3 (60%) were discharged within 36h. Indications for overnight admission were: optimisation of pain relief 4(80%) and pyrexia 1(20%).

All patients were happy or very happy with their anaesthesia and analgesia. No patients required readmission after discharge.

Statistically significant factors leading to admission are: length of operations (p=0.0007), not administering Diclofenac intraoperatively (p=0.003) and post-operatively (p=0.025), administering Cyclizine intraoperatively (p=0.002) and post operatively (p=0.001), adminstration of Morphine post-operatively (p=0.004) and not administering Ondansetron postoperatively (p=0.003).

Conclusions:

This audit showed that day case laparoscopic cholecystectomy service met its objectives with a low rate of overnight admission, and no readmissions. Patients were satisfied with their experience. The audit identified factors that could lead to overnight admission. These require further assessment in a larger cohort.


Session: Poster

Program Number: P391

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