TTP4.13 Readmissions After Cholecystectomy: Incidence, Causes and Healthcare Burden

Aim Readmissions within 30 days of cholecystectomy pose a significant healthcare burden, with Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS) setting the benchmark at <10%. This study examines the incidence, causes, and impact of 30-day readmissions following cholecystectomy. Methods This multicentre retrospective study included all adult patients undergoing elective and emergency laparoscopic cholecystectomy at three hospitals in single health board between August 2023 and July 2024. Data collected included demographics, operative details, and postoperative outcomes, including readmission rates and causes. Results 564 patients were identified, median age was 53 years and 404 (71.6%) were female. 210 (37.2%) were emergency cases. 212 (37.6%) patients also had intra-operative cholangiogram (IOC) and 72 (12.8%) patients also had laparoscopic bile duct exploration. 35 (6.2%) patients had readmission within 30-day of surgery. Median total hospital stay after readmission was 3 days (IQR 2-6). Causes of readmission included postoperative abdominal pain (11 patients), bile leak (5 patients), CBD stones (5 patients), and intra-abdominal collection (2 patients). Rare causes, each affecting one patient, included CBD stricture, AKI, C. difficile infection, cholangitis, constipation, DVT, fall, ileus, pancreatic insufficiency, stroke, port site infection, and transverse colon colitis. Conclusion Readmission rates are within the accepted range but can be improved. Common causes include postoperative pain, bile leaks, and CBD stones. Liberal use of IOC, meticulous surgical technique, effective analgesia, and discharge information leaflets may help reduce these complications and readmissions.