Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.2972
Peer-review started: December 19, 2016
First decision: February 9, 2017
Revised: February 24, 2017
Accepted: March 30, 2017
Article in press: March 30, 2017
Published online: April 28, 2017
Processing time: 132 Days and 16.9 Hours
To determine the incidence of readmission after cholecystectomy using 90 d as a time limit.
We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies.
We analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of 4.99%. Sixty-four point seven nine percent occurred after elective surgery (cholelithiasis or vesicular polyps) and 35.21% after emergency surgery (acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d.
The use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.
Core tip: The use of a 30-d cutoff point to determine the rate of readmissions may underestimate the true incidence of complications. The current tendency is to use 90 d as a time limit to measure complications associated with any surgical procedure. Our objective is to determine the incidence of readmission after cholecystectomy using this longer time limit.