Day-case laparoscopic cholecystectomy in a rural Australian hospital: a retrospective cohort study of safety and outcomes

Background: The demand for cost-effective surgical care has led to the wider adoption of day-case laparoscopic cholecystectomy (DCLC). The objective of this study was to assess the safety and outcomes of DCLC performed in a rural Australian hospital, quantify the unplanned admission rate and its causes, and compare these findings with published metropolitan data. Materials and methods: A retrospective observational cohort study of 68 consecutive patients with planned elective DCLC between January 2021 and August 2025 at a rural Australian hospital was conducted. Data were collected from paper-based medical records, recorded into the hospital database on an Excel spreadsheet, and included patient demographics, operative details, discharge outcomes, and readmissions within 7 days. Data were summarized using means, standard deviations, and percentages. Results: The mean patient age was 42.9 ± 14.7 years, and the mean BMI was 30.6 ± 5.3 kg/m 2 ; 75% were female, and 88% were American Society of Anesthesiologists grade I–II. A total of 68 patients were planned for elective DCLC, of which 63 (92.6%) successfully achieved same-day discharge. Seven-day readmission was 4.4%, and all were for minor postoperative reasons. A longer duration of operation and drain placement were the major contributors to failure of discharge. There was no surgical conversion to an open case and no severe postoperative complications. Conclusion: DCLC can be performed safely and effectively in a rural hospital and produces results comparable to those of metropolitan centers. Selective case identification, perioperative planning, and established discharge processes facilitate further expansion of same-day discharge in rural centers. Plain Language Summary: DCLC allows patients to return home on the same day after gallbladder removal. This study reviewed 68 patients treated at a rural Australian hospital between January 2021 and August 2025 to assess whether this approach is safe outside metropolitan centers. Most patients (92.6%) were able to go home on the same day, and only three returned to the hospital within a week for minor issues. No major complications occurred, and none required conversion to open surgery. These findings indicate that DCLC can be safely performed in a rural hospital setting.