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Study shows day case laparoscopic cholecystectomy is safe and can support post-pandemic elective recovery

Increasing day case rates for laparoscopic cholecystectomy (surgery to remove the gall bladder) is likely to be key if NHS systems are to increase activity levels up to and beyond pre-pandemic levels, according to a new GIRFT study.

Laparoscopic cholecystectomy is regularly performed as day-case surgery across England, but rates vary across regions and Integrated Care Boards (ICBs).

A GIRFT study published recently in the Annals of the Royal College of Surgeons of England – entitled Association of day-case rates with post COVID-19 recovery of elective laparoscopic cholecystectomy activity across England – identified that regions and ICBs with high day case rates had better post-pandemic recovery of activity relative to pre-pandemic levels, compared to regions and ICBs with low day case rates.

Data for more than 184,000 patients undergoing laparoscopic cholecystectomy from 2019-2022 was reviewed; in 2022, the number of procedures performed across England was 88% of the number performed in 2019.

However, rates in the South West of England recovered in the same period to 97% of pre-pandemic levels, while in the South East recovery was 82% of 2019 levels. In general, regions with the greatest recovery had the highest day case rate in 2022.  At an ICB level, the association between day case rates and recovery of activity was also significant.

The authors also found day case laparoscopic cholecystectomy to be safe, with day case patients having better outcomes than in-patients and ICBs with high and low rates of day case surgery having similar outcomes.

The study was carried out by:

  • Faraz Ayyaz: GIRFT clinical fellow
  • James Joyner: GIRFT clinical fellow
  • Mark Cheetham: GIRFT clinical lead for general surgery
  • Professor Tim Briggs: GIRFT chair and NHS England’s National Director for Clinical Improvement and Elective Recovery
  • William Gray: GIRFT’s academic content lead

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