Abidemi Adesuyi, David Bunting
Royal Devon University Healthcare NHS Foundation Trust, North Devon, United Kingdom
Introduction: Laparoscopic cholecystectomy is the most performed hepatobiliary procedure in the United Kingdom and worldwide. Readmission rate following surgery is considered a problem as such, reducing this will allow for effective cost savings in the National Health Service. The aim was to determine 30-day readmission rate post-laparoscopic cholecystectomy, identify the indications for readmission and aim to reduce this rate.
Methods: We carried out a retrospective analysis of data of patients that had cholecystectomies over a 3-year period; 2019-2021 in our facility. Demographic data, comorbidity, and 30-day readmission rate over three-year and three-time periods were evaluated. Findings were presented at the Upper Gastrointestinal meeting and subsequently, we implemented that all our patients get standard analgesic post-laparoscopic cholecystectomy and subsequently a reaudit was conducted.
Results: A total of 883 patients had laparoscopic cholecystectomy: 69% females and 31% males. 70% were performed as day case. Readmission rate was 6% (5%; day case and 6%; overnight-cases), also, 4%, 6% and 6% for years 2019, 2020 and 2021 respectively. Indication for readmission was 22% and 78% for biliary and non-biliary causes. Common indications for readmission were abdominal pain, postoperative infection, retained stone, pancreatitis and bile leak with non-specific abdominal pain being the commonest. Following adjustment for comorbidity, increasing age, and male gender were associated with an increased rate for admission.
Conclusion: Readmission rates following laparoscopic cholecystectomy in North Devon District Hospital over a three-year period was less than 10% in accordance with Association of Upper Gastrointestinal Surgeons standards. Standards have been maintained following a reaudit.