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Hepatobiliary I
PTU-079 Prospective audit of readmission following emergency and elective cholecystectomy in a single health board
  1. E J Barron1,
  2. J P Blackmur1,
  3. R McMurray2,
  4. E M Harrison1,
  5. T E Gillies3,
  6. J Garden1
  1. 1Clinical and Surgical Sciences (Surgery), Edinburgh, UK
  2. 2University of Edinburgh, Edinburgh, UK
  3. 3General surgery, Royal Infirmary Edinburgh, Edinburgh, UK

Abstract

Introduction Surgical outcome indicators, such as hospital stay, readmission and mortality rates, are increasingly being used to assess and compare hospital board performance and considerable variation exists between hospitals specifically in readmission rates. The aim of the study was to determine true readmission rates following cholecystectomy in a single large volume centre to determine whether readmission was potentially preventable.

Methods All patients readmitted to one large teaching hospital surgical service within 28 days following elective or emergency cholecystectomy from September 2010 to June 2011 were audited prospectively.

Results Of 979 cholecystectomies performed during the period, 57 (5.8%) patients were readmitted. 38 of the 57 (67%) readmissions followed emergency-admission with symptomatic gallstone disease and 51 of these (89.5%) had undergone a laparoscopic approach. 34/979 (3.5%) were considered to be secondary to demonstrable complications of surgery with the most common cause being retained stones (11). No patient presented with bile duct injury, and there were no deaths. Only 14 of the readmitted patients (25%) required intervention: one required sub-phrenic abscess drainage, nine endoscopic-retrograde-cholangiopancreatography and sphincterotomy (ERCP), two completion cholecystectomy, one laparoscopic assessment following ERCP for bile leak and one underwent hepatico-jejunostomy for definitive management of an irretrievable retained stone following ERCP and laparoscopic bile duct exploration. Of those readmitted, the most common cause of presentation was non-specific abdominal pain (15 (26.3%)) with no cause found.

Conclusion Readmission rate in this large volume centre was low. Most patients readmitted following cholecystectomy have demonstrable surgically related complications but few require definitive surgical management. Further work is being conducted to define potential predictive factors for readmission.

Competing interests None declared.

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