title: A 5-year analysis of readmissions following elective laparoscopic cholecystectomy - cohort study.
abstract: OBJECTIVE
  This study aimed to determine readmission rates, causes for readmission and outcomes for patients undergoing elective Laparoscopic Cholecystectomy (LC) without intraoperative cholangiogram (IOC).
  
  
  METHODS
  Timing related to readmissions was grouped as <6 weeks, 6 weeks-1 year, 1-2 years and >2 years. Outcomes and variables related to readmission were evaluated.
  
  
  RESULTS
  101 readmissions (6.6) were noted amongst 1523 consecutive LC. The median follow up was 4 years (range 1.6-6.4 years). There was no difference in the median age (48 vs. 53 years, P = 0.2) and sex of the patients between the readmitted and no readmission groups. The incidence of readmissions (n = 101) within the first 6 weeks, 6 weeks-1 year, 1-2 years and >2 years were 2.8%, 1.5%, 1.4% and 0.7% respectively. The most common reasons for readmissions were non-specific abdominal pain (NSAP) (36%), obstructive jaundice (14%), peptic ulcer disease (10%), intra-abdominal collection (4%) and bile leak (3%), pancreatitis (3%), and other reasons (30%). Overall, 24 (22%) of readmissions were related to biliary problems, the majority of these occurred (15/24, 63%) within 6 weeks of LC. The incidence of retained stones within the first 6 weeks, 6 weeks-1 year, 1-2 years and >2 years were 0.4%, 0.3%, 0.1% and 0% respectively. Overall 14 (14%) patients were readmitted with retained stones and all were managed by ERCP & ductal clearance.
  
  
  CONCLUSIONS
  Readmission rate following elective LC is low with the majority occurring within the first 6 weeks and only a quarter of these related are directly to biliary pathology. In the absence of routine IOC, around 1% of patients present with retained stones within 2 years of LC. A small fraction of patients continue to suffer from NSAP and should be warned prior to the surgery.
authors.affiliation: Ninewells Hospital and Medical School, Dundee, UK. sanjay.pandanaboyana@nhs.net
authors.forename: P
authors.initials: P
authors.lastname: Sanjay
authors.forename: R
authors.initials: R
authors.lastname: Weerakoon
authors.forename: I A
authors.initials: IA
authors.lastname: Shaikh
authors.forename: T
authors.initials: T
authors.lastname: Bird
authors.forename: A
authors.initials: A
authors.lastname: Paily
authors.forename: S
authors.initials: S
authors.lastname: Yalamarthi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005705:Gallbladder Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult