Abstract Background Laparoscopic cholecystectomy is a common procedure for gallstone disease, with national targets recommending a 75% day-case completion rate to improve patient care and optimize healthcare resources. This audit evaluates factors influencing day-case success at Ealing Hospital to identify opportunities for improvement. Methodology A retrospective analysis was conducted on 71 elective laparoscopic cholecystectomies performed between January and July 2024. Data, including patient demographics, surgical duration, recovery times, intraoperative findings, and surgery start and end times, were analyzed to identify predictors of day-case success. Emergency cases and incomplete records were excluded. Results Of the 71 cases, 64 (90.1%) were booked as day cases, with a success rate of 74.4%. Age was a significant predictor, with patients under 60 achieving higher success rates (82.4%) compared to those aged 60–79 (55.6%) and over 80 (33.3%) (p=0.002). Surgical duration strongly influenced success, with operations lasting ≤120 minutes significantly more likely to succeed (OR 2.1, p=0.015). Although early morning surgeries achieved slightly better outcomes (76.9%), start and end times were not statistically significant predictors. Intraoperative findings such as normal anatomy correlated with higher success rates (72.4%), while adhesions (60%) and large gallbladders (33.3%, p=0.048) reduced success. Drain placement, comorbidities, and postoperative pain were common reasons for overnight stays, with only 37% of failures anticipated preoperatively. Conclusion Achieving a day-case success rate of 74.4% aligns closely with national targets. Younger age, shorter surgical duration, and straightforward anatomy were key predictors of success. Enhanced patient selection and surgical efficiency can further optimize outcomes.
Almoshantaf et al. (Fri,) studied this question.