291 Day Case Laparoscopic Cholecystectomy Rate at Great Western Hospital, Swindon

Abstract Introduction Laparoscopic cholecystectomy (LC) is the gold standard for treating gallstones. The British Association of Day Surgery (BADS) Directory of Procedures suggests a target day-case rate of 75%. Method A retrospective review was conducted of all patients who underwent DCLS at a district general hospital between January 2024 and December 2024. Results During the study period, 499 elective LCs were performed. 311 cases (62.3%) were initially booked into the system as day case procedures. The median patient age was 53 years (range: 18–90).445 patients (89.2%) were younger than 75 years. 22 (4.4%) of the cohort had a hot gallbladder (HGB) slot. Of these, 317 (63.5%) were completed as true-day cases (TDC), and 64.9% of them are younger than 75 years old. An additional 76 patients (15.2%) were initially intended for same-day discharge but required an unexpected overnight stay (UOS), while 106 patients (21.2%) were planned for inpatient admission. The most frequent reason documented for UOS was pain (n=18, 24%), followed by abnormal vitals (n=11, 14%) and then nausea/vomiting (n=9, 12%). Other reasons included wound issues (e.g., bleeding, drain complications) and social factors. Notably, 26 patients (41%) had no clearly documented reason for admission. Conclusions The Day Case Surgery Unit achieved a TDC rate of 63.5%, which remains below the 75% benchmark recommended by the UK Department of Health. A significant proportion of UOS cases were due to postoperative pain and unspecified causes. A high proportion of patients were booked in as inpatients, which likely represents an error during the booking process.