Abstract Aims Day-case laparoscopic cholecystectomy is safe, cost-effective and patient friendly; however, some planned day case patients may convert to in-patient stay following an elective laparoscopic cholecystectomy. The aim of this study was to determine the rate of conversion from planned day-case to in-patient laparoscopic cholecystectomy across England and trends in same-day discharge over the study period. This study also aimed to evaluate factors contributing to these conversions. Methods This was an exploratory analysis of administrative data from the Hospital Episode Statistics (HES) database for England of planned day-case laparoscopic cholecystectomies from April 2017 to March 2024. Results Of 286,754 planned day-case patients, the conversion rate to in-patient stay was 26.1% (74,957). Patients who converted to in-patient stay were older, more likely to be male and have open surgery, more comorbidities and were more likely to be operated on by a low annual volume surgeon. Post-procedural complications of haemorrhage, pain and venous thromboembolism were strongly associated with conversion. Across the 42 ICBs in England, model-adjusted conversion rates varied from 14.5% to 39.0%. Conversion to in-patient stay was associated with higher emergency hospital admissions within 30 days of discharge (4,290, 5.7%) when compared with same-day discharge (8,306 3.9%). Conclusions The rate of conversion from planned day-case to in-patient laparoscopic cholecystectomy across England have declined over the past 7 years. Our study highlights patient selection, intra-operative haemostasis, and peri-operative pain management as target areas for centres hoping to improve day-case laparoscopic cholecystectomy rates.
Olagunju et al. (Fri,) studied this question.