How safe is same-day discharge after laparoscopic sleeve gastrectomy?

Abstract

BackgroundLaparoscopic sleeve gastrectomy (LSG) is associated with low morbidity and mortality and a short length of stay. Studies on the safety of same-day discharge after LSG are limited. ObjectiveTo compare outcomes between same-day versus first-postoperative-day (POD1) discharge after LSG. SettingMetabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database. MethodsThe 2015 to 2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was analyzed for elective LSG cases with same-day or POD1 discharge. Open, revisional, and converted cases were excluded. Multivariate analysis was performed to compare adjusted 30-day mortality, morbidity, readmission, and reoperation for same-day versus POD1 discharge. ResultsWe examined 85,321 LSG cases, including 4728 same-day discharges and 80,593 POD1 discharges. Compared with POD1 discharges, same-day discharges were associated with higher overall morbidity (1.31% versus .84%, respectively; adjusted odds ratio [AOR] 1.72; P = .0002), a higher readmission rate (2.14% versus 1.64%, respectively; AOR 1.40; P = 0.0034), and a higher reoperation rate (.61% versus .27%, respectively; AOR 2.35; P < .0001). There was no difference in mortality (.08% versus .04%, respectively; AOR 2.62; P = .0923). ConclusionSame-day discharge after LSG is associated with increased complications, readmissions, and reoperations compared with POD1 discharge. Further studies are needed to examine objective criteria for safe same-day discharge after LSG.