BN SO09 - Same day discharge after laparoscopic cholecystectomy: Getting It Right First Time (GIRFT)

Abstract Background A key component of elective recovery strategy is to increase day-case provision. GIRFT standards recommend that at least 85% of elective laparoscopic cholecystectomies (LC) should day-cases; most hospitals struggle to achieve this and we aimed to identify barriers to same day discharge after LC. Method Consecutive patients who had LC between December 2022 and March 2023 were identified. Electronic patient records were interrogated to analyse outcomes, length of stay and in-patient treatment. Results 138 patients included, 93 (67%) had elective surgery: ConditionNumber of patients (%)Proportion of elective:acuteBiliary Colic66 (47.5%)60:6 (91.0%:9.0%)Pancreatitis17 (12.2%)4:13 (23.5%:76.5%)Cholecystitis40 (30.0%)19:21 (47.5%:52.5%)CBD stones11 (7.9%)8:3 (72.7%:27.3%)Gallbladder polyp2 (1.4%)2:0 (100%:0%)Cholecystitis and CBD stones2 (1.4%)2:0 (100%:0%) 66 elective patients (70%) were discharged on the same day. Common reasons for staying overnight were late finish (11, 15%), drain or antibiotics (10, 14%) and anaesthetic reasons (10, 14%). Of admitted patients, 15 (21%) did not have any post-operative investigations and 21 (30%) had no in-patient treatment. Conclusion Most patients were managed on a day-case basis, though not to national GIRFT standards. Of admitted patients, 30% did not need in-patient treatment; these patients could have safely been sent home and had they been, the unit would have met national standards. These results highlight the potential for an extended stay area or a post-operative next-day treatment area to increase day-case activity.