O041 Utilising digital follow-up after elective laparoscopic cholecystectomy: a feasibility study

Abstract

Abstract Introduction Cholecystectomy is one of many operations performed nationally for which routine postoperative follow-up is no longer offered. National guidelines recommend patients are offered a postoperative helpline or telephone follow-up (TFU) appointment at discharge. Whilst the benefits of TFU are well documented, the use of digital modalities is less so. The objective of this study was to identify if digital follow-up (DFU) using an online platform, was equivalent to TFU. Methods Patients listed for elective laparoscopic cholecystectomy between August 2016 and March 2018 were given free choice to opt for postoperative DFU or routine postoperative care (TFU or no follow-up) at a tertiary referral centre in Nottingham. Primary objectives were to identify the incidence of 30-day postoperative complications identified by DFU compared with TFU. Secondary objectives were identifying the incidence of readmissions at 30-days, reoperations at 30-days, the incidence of missed complications at 30-days, and compliance with follow-up between groups. Results Of 597 patients undergoing laparoscopic cholecystectomy, 199 (33.3%) opted for TFU, and 98 for (16.4%) DFU. DFU was completed for 85 (86.7%) participants and TFU for 125 (62.8%), p<0.0001. Over 5 times as many patients who chose TFU missed their appointment compared with choosing DFU (5.6% vs. 30.9%, p < 0.001). DFU was completed earlier than TFU (median 6 days vs. 13.5 days, p=0.001) with high patient acceptability, identifying complications and alerting clinicians to those patients requiring early review. Conclusion This feasibility study has demonstrated that DFU is an acceptable alternative to TFU after elective laparoscopic cholecystectomy.