None listed
Conditions
Brief summary
DCLC has been implemented overseas for a number of years with success in reducing costs without compromising patient quality. Uptake in Australia is still sporadic as traditionally patients scheduled for elective Laparoscopic Cholecystectomy (Lap Chole) at our institution and others are admitted on the same day of surgery and discharged the following day. In early 2023, Werribee Mercy Health implemented elective DCLC in attempt to increase efficiency, reduce burden on the public health system whilst not compromising on quality of patient care. A policy was designed for patient selection along with a detailed perioperative protocol. The aim of this study is to review the effectiveness DCLC at our institution in comparison with that in literature.
Interventions
A retrospective study of patients who underwent elective Day Case Laparoscopic Cholecystectomy during a 12-month period in 2023 and 2024 was performed. Data was obtained by reviewing patient records after they underwent their procedure to gather information as to rates of complications which necessitated that the patient remain admitted. The exposure group of interest is those who underwent a day case gallbladder surgery.
Sponsors
Werribee Mercy Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria Same day discharge for Lap Cholecystectomy - The procedure is performed on an AM list or 1st on a PM list. · - The patient has no contraindications for same day surgery. - Patient has another adult in the same household who can provide support and assistance to the patient until the following day and as required. - The patient resides within 20 km of Werribee Mercy Hospital. - The patient is prepared to attend an Emergency Department overnight if they require medical assistance. - The suitability of same day discharge for any patient undergoing a Laparoscopic Cholecystectomy must be undertaken in consultation with the attending Surgical Consultant All data were for patients admitted in 2023 and 2024. Subgroup (control vs intervention) analysis only occurred after data collection. Patients were allocated to each group depending on if they successfully achieved a same-day discharge or not. As such exposure group inclusion criteria was functionally the same as Day-case group, except the patients failed to be discharged on the same day.
Exclusion criteria
Exclusion criteria · Unable to confirm an adult can be available in the same household to provide support and assistance to the patient as required. · Patient lives outside a 20 km radius from WMH. · Age>65 · BMI>35 · Significant co-morbidity which requires close monitoring for the peri-op period for best patient outcomes. · History of severe Post-Operative Nausea & Vomiting (PONV). · Patient has sleep apnoea. · ASA is above 2. · Stones in the Common Bile Duct (CBD). · Patient is on anticoagulant therapy. · Gallbladder wall thickening. · Stones in the CBD, based on Ultrasonic review, CT or Liver Function Tests (LFTs). · Opioid, alcohol and other substance dependency. · Previous upper abdominal surgery.
Outcome results
None listed