Thirty-Day Unplanned Readmission After Ambulatory Laparoscopic Cholecystectomy in Western China: A Retrospective Study

Abstract

Background Day surgery has been gradually accepted by health professions globally, which can shorten the hospital stay and reduce medical costs. The ambulatory laparoscopic cholecystectomy (LC) has been performed in China since over 10 years. However, few studies focus on its 30-day unplanned readmission rate of ambulatory LC and no standard of unplanned readmission rate for that now. Purpose This study aimed to evaluate the unplanned readmission rate and the reasons readmission after ambulatory LC in a tertiary hospital, which is the earliest ambulatory surgery implementation place in western China. Methods A retrospective analysis was conducted. The patients who underwent ambulatory LC from September 2015 to September 2019 in West China Hospital were screened. The 30-day unplanned readmission rate was calculated as the first outcome. The reasons for unplanned readmission were analyzed and classified as the second outcome. Results The study included 3,014 patients, and the unplanned readmission rate was 1.53%. The rate of patients diagnosed with cholecystolithiasis with cholecystitis was significantly higher in the unplanned readmission group (73.9% vs. 48.9%, p=0.003), and medical cost of unplanned readmission patients was significantly more than that of non-readmission patients (8,102.4±1,375.7 Yuan vs. 7,574.61±10,14.0 Yuan; p=0.008). It was observed that 71.7% readmission happened in the first seven days. Wound problems (60.9%) and abdominal pain (26.1%) went the two main reasons for unplanned readmission. Conclusions The analysis revealed that the unplanned readmission rate of 1.53% was low for ambulatory LC. Some causes of unplanned readmission, such as abdominal pain and wound site pain, wound exudate could be reduced by some simple interventions of the clinical professions.

Preoperative admission is non-essential in most patients receiving elective laparoscopic cholecystectomy: A cohort study

“…This means the study findings reflect real-world practice data. The traditional approach to preoperative admission is still prevalent in many countries, including those in Asia and other developing nations [ 6 – 8 ]. This study’s representation of actual practice data provides valuable insights into overnight-stay LC.…”

“…In Western countries, practices have shifted toward ambulatory or daycare LC, where patients are able to return home on the same day as their surgery [ 4 , 5 ]. However, daycare surgery has yet to gain widespread acceptance in Asia, particularly in developing countries [ 6 – 8 ].…”

Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand: Assessing effectiveness and safety with a propensity score matched analysis

“…Ambulatory LC, also known as day-case or outpatient LC, is an opportunity for healthcare systems, especially in developing countries, to optimize resource utilization and reduce costs [3]. While in the USA and UK, it has become standard practice over the last two decades [4,5], in Asia and Thailand, its adoption has been limited, due to concerns about postoperative complications [6][7][8]. In Thailand, the One Day Surgery (ODS) policy, introduced in 2018 and including LC in 2021, is aligned with global efforts to reduce hospital stays and healthcare expenses, addressing issues like hospital congestion and infection risks.…”

Efficacy of a new day surgery management mode based on WeChat: a study protocol for randomised controlled trials

“…The patient and their caregiver play a major role in postoperative recovery management. 21 Usually, hospital nurses usually send the patient a pamphlet and provide health education prior to surgery. The patient receives a lot of information related to the surgery, but he or she does not understand the point of learning all of this information.…”

“…However, this situation is different in China. The patient and their caregiver play a major role in postoperative recovery management 21. Usually, hospital nurses usually send the patient a pamphlet and provide health education prior to surgery.…”