Digital Follow-Up After Elective Laparoscopic Cholecystectomy: A Feasibility Study

Daliya, Prita; Carvell, Jody; Rozentals, Judith; Lobo, Dileep N.; Parsons, Simon L

Abstract

Background: Although recommendations exist for patients to be offered a post-operative helpline or telephone follow-up appointment at discharge after cholecystectomy, implementation of these is resource-intensive. Whilst the benefits of telephone follow-up are well documented, the use of digital modalities is less so. We aimed to identify if digital follow-up (DFU) was equivalent to routine care with telephone follow-up (TFU), for patients undergoing elective laparoscopic cholecystectomy. Methods: All patients listed for elective laparoscopic cholecystectomy between August 2016 and March 2018 were offered routine post-operative care (TFU or no follow-up) or DFU at a tertiary referral centre in Nottingham. Results: Of 597 patients undergoing laparoscopic cholecystectomy, 199 (33.3%) opted for TFU, and 98 (16.4%) for 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 to DFU (5.6% vs. 30.9%, p < 0.001). At 30-days post-operatively, patients undergoing TFU had significantly more post-operative wound infections identified then those undergoing DFU (17.6% vs 5.9%, p = 0.01). However, this did not impact the incidence of 30-day readmissions between groups (7.2% TFU vs. 7.1% DFU). No complications were missed by either the DFU or TFU modalities. DFU was completed significantly earlier than TFU (median 6days vs. 13.5days, p = 0.001) with high patient acceptability, identifying complications and alerting clinicians to those patients requiring an early review. Conclusion: This feasibility study has demonstrated that digital follow-up is an acceptable alternative to telephone follow-up after elective laparoscopic cholecystectomy.

Citation

Daliya, P., Carvell, J., Rozentals, J., Lobo, D. N., & Parsons, S. L. (2022). Digital Follow-Up After Elective Laparoscopic Cholecystectomy: A Feasibility Study. World Journal of Surgery, 46, 2648-2658. https://doi.org/10.1007/s00268-022-06684-w

• Journal Article Type: Article
• Acceptance Date: Jul 16, 2022
• Online Publication Date: Aug 11, 2022
• Publication Date: Nov 1, 2022
• Deposit Date: Oct 2, 2022
• Publicly Available Date: Oct 3, 2022
• Journal: World Journal of Surgery
• Print ISSN: 0364-2313
• Electronic ISSN: 1432-2323
• Publisher: Springer Science and Business Media LLC
• Peer Reviewed: Peer Reviewed
• Volume: 46
• Pages: 2648-2658
• DOI: https://doi.org/10.1007/s00268-022-06684-w
• Keywords: Surgery
• Public URL: https://nottingham-repository.worktribe.com/output/10627571
• Publisher URL: https://link.springer.com/article/10.1007/s00268-022-06684-w