A Single Centre Experience of Day Case Laparoscopic Cholecystectomy Outcomes by Body Mass Index Group

Aim. The purpose of this study was to evaluate whether patients with a high BMI can undergo safe day case LC for cholecystitis compared to groups of patients with a lower BMI. Setting. NHS District General Hospital, UK. Methods. A retrospective review of 2391 patients who underwent an attempted day case LC between 1 January 2009 and 15 August 2015 was performed. Patients were divided into five groups depending on their BMI. Inclusion criteria were patients undergoing elective day case laparoscopic cholecystectomy with cholecystitis on histology. The endpoints were complication requiring readmission and postoperative length of stay (LOS). Results. There were 2391 LCs performed in the time period of which 1646 were eligible for inclusion. These LCs were classified as 273 (16.9%), 608 (37.8%), 428 (26.6%), 208 (12.9%), and 91 (5.66%) patients in the groups with BMI values of 18.5–24.9, 25–29.9, 30–34.9, 35–39.9, and >40, respectively. Average BMI was 30.0 (±5.53, 19–51) with an average postoperative LOS of 0.86, and there was no difference between the BMI groups. Overall complication rate was 4.3%; there was no significance between BMI groups. Conclusions. Increased BMI was not associated with worse outcomes after day case LC.

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EPS2.05 Arm circumference and skinfolds vs. body mass index: a single-centre experience over two decades

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(21)01012-2 ◽

2021 ◽

Vol 20 ◽

pp. S33

Author(s):

D. Appelt ◽

G. Steinkamp ◽

M. Dumke ◽

H. Ellemunter

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Single Centre ◽

Arm Circumference ◽

Single Centre Experience

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Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

Journal of Perioperative Practice ◽

10.1177/1750458920977418 ◽

2021 ◽

pp. 175045892097741

Author(s):

Zoe Hinchcliffe ◽

Imran Mohamed ◽

Anil Lala

Keyword(s):

Laparoscopic Cholecystectomy ◽

General Hospital ◽

Univariate Analysis ◽

District General Hospital ◽

Day Case ◽

Patient Factors ◽

Surgical Services ◽

North Wales ◽

Selection For ◽

The Uk

Background The UK practice of laparoscopic cholecystectomy has reduced during the COVID-19 pandemic due to cancellation of non-urgent operations. Isolated day-case units have been recommended as ‘COVID-cold’ operating sites to resume surgical procedures. This study aims to identify patients suitable for day case laparoscopic cholecystectomy (DCLC) at isolated units by investigating patient factors and unexpected admission. Method Retrospective analysis of 327 patients undergoing DCLC between January and December 2018 at Ysbyty Gwynedd (District General Hospital; YG) and Llandudno General Hospital (isolated unit; LLGH), North Wales, UK. Results The results showed that 100% of DCLCs in LLGH were successful; 71.4% of elective DCLCs were successful at YG. Increasing age ( p = 0.004), BMI ( p = 0.01), ASA Score ( p = 0.006), previous ERCP ( p = 0.05), imaging suggesting cholecystitis ( p = 0.003) and thick-walled gallbladder ( p = 0.04) were significantly associated with failed DCLC on univariate analysis. Factors retaining significance (OR, 95% CI) after multiple regression include BMI (1.82, 1.05–3.16; p = 0.034), imaging suggesting cholecystitis (4.42, 1.72–11.38; p = 0.002) and previous ERCP (5.25, 1.53–18.00; p = 0.008). Postoperative complications are comparable in BMI <35kg/m2 and 35–39.9kg/m2. Conclusions Current patient selection for isolated day unit is effective in ensuring safe discharge and could be further developed with greater consideration for patients with BMI 35–39.9kg/m2. As surgical services return, this helps identify patients suitable for laparoscopic cholecystectomy at isolated COVID-free day units.

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Management of choledocholithiasis in an emergency cohort undergoing laparoscopic cholecystectomy: a single-centre experience

HPB ◽

10.1111/hpb.12187 ◽

2014 ◽

Vol 16 (7) ◽

pp. 629-634 ◽

Cited By ~ 8

Author(s):

Benjamin Poh ◽

Paul Cashin ◽

Kaye Bowers ◽

Travis Ackermann ◽

Yeng Kwang Tay ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Centre ◽

Single Centre Experience

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‘True Day Case’ Laparoscopic Cholecystectomy in a High-Volume Specialist Unit and Review of Factors Contributing to Unexpected Overnight Stay

Minimally Invasive Surgery ◽

10.1155/2018/1260358 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

A. Solodkyy ◽

A. R. Hakeem ◽

N. Oswald ◽

F. Di Franco ◽

S. Gergely ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Preoperative Assessment ◽

High Volume ◽

District General Hospital ◽

Day Case ◽

Day Case Surgery ◽

Overnight Stay ◽

Same Day Discharge ◽

Case Surgery ◽

Overnight Stays

Introduction. Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstones. British Association of Day Case Surgery recommends at least 60% of LCs be performed as day cases. The aim of this study was to assess our rate of true day case LCs and review factors preventing same-day discharge. Methods. We prospectively collected data of all elective LCs performed in a district general hospital over 32 months. Results. 500 patients underwent LC during this period; 438 (88.2%) patients were planned day cases and 59 patients (11.8%) planned overnight stays. Of the planned day cases, 75.8% (n=332) were discharged on the same day and 106 (24.2%) had unexpected overnight stay (UOS). Most patients with BMI >35 and ASA3 planned day case patients were successfully discharged. Drain insertion, longer operations, and late recovery departure were the main reasons for UOS. There were more complications in this group compared to day cases. Conclusions. This unit has a high ‘true day case’ rate of 75.8%. High BMI and ASA3 should not be absolute contraindications to day case surgery. The majority of unexpected overnight stays are unavoidable but may be reduced by patient selection, stringent preoperative assessment, operation scheduling, and reduction in unnecessary drain insertion.

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