Quality of recovery assessment of day case and multiday stay patients undergoing elective laparoscopic cholecystectomy
Matthew Campbell1, Daniel Ng1, Batool Albatat1, Darren Lowen2, David Bird1, Russell Hodgson1
1Clinic of General Surgery, Northern Health Hospital, Epping, Australia
2Clinic of Anaesthetics, Northern Health Hospital, Epping, Australia
Objective: Many laparoscopic cholecystectomy operations are performed with at least overnight admission. Current research shows that laparoscopic cholecystectomy is safe and feasible to do as a day case. Patient centred outcomes are less well understood.
Material and Methods: Elective laparoscopic cholecystectomy patients at a single metropolitan hospital in Melbourne, Australia were surveyed 24 hours after surgery using the 15-question Quality of Recovery (QoR-15) survey. A comparison was made between day case surgeries and multi-day surgeries.
Results: One hundred and eight patients were recruited consisting of 34 day case and 74 multi-day patients. Patient groups did not differ in terms of age, sex or postoperative morbidity. The multi-day group had a higher proportion of comorbid patients (p-value = 0.03). There was no significant dif- ference in overall QoR-15 score between the two groups, although there was an observed trend towards a higher score in the day case group (132.0 vs 127.9, p= 0.147). QoR-15 individual question results showed that day cases rated significantly better for sleep quality and for less feelings of anxiety or worry. The differences narrowed when comparing patient groups as they were booked (intention-to-treat). There were no identified sub-groups that had a significantly higher score if admitted multi-day.
Conclusion: Quality of recovery following day case laparoscopic cholecystectomy is just as good, if not better, than multi-day cases. Laparoscopic cholecystectomy as a day case is both safe and economically superior to multi-day management. This gives further weight to current recommendations suggesting that the majority of laparoscopic cholecystectomy operations could be performed as day cases.
Keywords: Laparoscopic cholecystectomy, gallstones, day case, quality of recovery
This study approval was obtained from Northern Health Hospital Human Research Ethics Committee (Decision no: ALR 16.2018, Date: 20.06.2018).
Author Contributions: Concept - D.L., D.B., R.H.; Design - D.L., R.H.; Supervision - D.B., R.H.; Data Collection and/or Processing - D.B., B.A.; Analysis and/or Interpretation - M.C., B.A., R.H.; Literature Search - M.C., D.B., R.H.; Writing Manuscript - M.C.; Critical Reviews - All of authors.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.