Introduction: Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallstones and its practice as day case where possible is considered the standard over the last decade. However, readmission after surgery is recognised as a new problem.
Aim: The aim of this cohort observational study was to investigate the readmission rate in a district general hospital and identify the causes of readmission in order to explore ways by which this can be reduced or managed more cost effectively.
Method: Records of patients who had laparoscopic cholecystectomy over 6 months were retrospectively searched. Patients returning to hospital due to symptoms within 30 days of elective and emergency laparoscopic cholecystectomy were included.
Results: Three hundred and twenty-eight laparoscopic cholecystectomies were performed within the 6-month period. Twenty-two patients returned within 30 days of surgery making a readmission rate of 6.7%. Reasons for inpatient admission were abdominal pain without any underlying cause 10 (45.5%), wound infection 5 (22.7%), leg swelling 2 (9%), retained stone 1 (4.5%), bile leak 1 (4.5%), pneumonia 1 (4.5%), iatrogenic bowel injury 1 (4.5%) and back pain 1 (4.5%). Readmission rate decreased with longer duration of stay in hospital during primary admission, and 64% of patients returned to the hospital within 7 days of procedure. 50% of patients who returned with abdominal pain without any identifiable cause had a longstanding history of conditions involving chronic pain.
Conclusion: While the feared intra-abdominal complications of cholecystectomy often come to mind when assessing patients presenting with abdominal pain after surgery, non-specific abdominal pain is consistently shown to be several times more likely. A combination of patient factors and pain control techniques account for this pain. Effective multimodal pain management approach and community primary health care support in the early post-operative period could reduce readmission, save cost and improve patient experience.
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http://dx.doi.org/10.1007/s00464-016-5380-1 | DOI Listing |
JSLS
January 2025
Attending Consultant Department of Minimal Access, Bariatric and Robotic Surgery, MAX Superspeciality Hospital Vaishali and Patparganj, Delhi National Capital Region, India. (Dr. Ahmed).
Background And Objective: Robotic cholecystectomy has technical advantages of 3D visualization, enhanced instrument maneuverability, and increased precision. Less chance of conversion to open and biliary spillage. This study explores the utilization of the BORNS Simphoni Robotic System for robotic cholecystectomy.
View Article and Find Full Text PDFScand J Gastroenterol
January 2025
Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Background: Cholecystectomy often disrupts autonomic balance, impacting recovery. Remote ischemic preconditioning (RIPC) may enhance ANS function and protect organs, but its role in cholecystectomy is unclear.
Methods: In this randomized controlled trial, 80 patients aged 45 to 65 years, scheduled for elective laparoscopic cholecystectomy, were randomly assigned to either the RIPC group or the control group.
Am J Surg
December 2024
Upper GastroIntestinal Unit, Department of Surgery, St George Public Hospital, NSW Health, Australia; UNSW Department of Surgery, St George & Sutherland Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
Background: Laparoscopic cholecystectomy (LC) is a common operation performed worldwide. Indications include acute cholecystitis (AC), with a trend of increasing complexity post-COVID-19. We aim to evaluate the health expenditure on LC at an Australian tertiary centre.
View Article and Find Full Text PDFAbdom Radiol (NY)
December 2024
University of Kentucky, Lexington, USA.
Post-surgical biliary complications increase morbidity, mortality, and healthcare utilization. Early detection and management of biliary complications is thus of great clinical importance. Even though the overall risk for biliary complications is low after laparoscopic cholecystectomy, post-cholecystectomy biliary complications are frequently encountered in clinical practice as laparoscopic cholecystectomy is the most common surgical procedure performed in the United States.
View Article and Find Full Text PDFminimally invasive surgery is the surgery of the present and has become the "gold standard" for the most pathologies. The training of surgeons in minimally invasive techniques is mandatory required to be carried out during the residency program. In Romania, there is no national minimally invasive surgical training program, only universities and certain university hospitals are concerned with this aspect.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!