Type of publication:
Conference abstract
Author(s):
*Olagunju N.; *Cheetham M.; Briggs T.; Gray W.K.
Citation:
British Journal of Surgery. Conference: Annual Congress of the Association of Surgeons of Great Britain and Ireland. Edinburgh United Kingdom. 112(Supplement 13) (pp xiii25), 2025. Date of Publication: 01 Aug 2025.
Abstract:
Aims: Day-case laparoscopic cholecystectomy is safe, cost-effective and patient friendly; however, some planned day case patients may convert to in-patient stay following an elective laparoscopic cholecystectomy. The aim of this study was to determine the rate of conversion from planned day-case to in-patient laparoscopic cholecystectomy across England and trends in same-day discharge over the study period. This study also aimed to evaluate factors contributing to these conversions. Method(s): This was an exploratory analysis of administrative data from the Hospital Episode Statistics (HES) database for England of planned day-case laparoscopic cholecystectomies from April 2017 to March 2024. Result(s): Of 286,754 planned day-case patients, the conversion rate to in-patient stay was 26.1% (74,957). Patients who converted to in-patient stay were older, more likely to be male and have open surgery, more comorbidities and were more likely to be operated on by a low annual volume surgeon. Post-procedural complications of haemorrhage, pain and venous thromboembolism were strongly associated with conversion. Across the 42 ICBs in England, model-adjusted conversion rates varied from 14.5% to 39.0%. Conversion to in-patient stay was associated with higher emergency hospital admissions within 30 days of discharge (4,290, 5.7%) when compared with same-day discharge (8,306 3.9%). Conclusion(s): The rate of conversion from planned day-case to in-patient laparoscopic cholecystectomy across England have declined over the past 7 years. Our study highlights patient selection, intra-operative haemostasis, and peri-operative pain management as target areas for centres hoping to improve day-case laparoscopic cholecystectomy rates.
DOI: 10.1093/bjs/znaf166.094
