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Equivalent Peri-Operative Outcomes for Laparoscopic Roux-En-Y Gastric Bypass Patients Discharged on Post-Operative Day One

  • Jarrod M BuzalewskiEmail author
  • Mark E Mahan
  • Marcus Fluck
  • James Dove
  • Ryan D Horsley
  • David M Parker
  • Anthony T Petrick
  • Jon D Gabrielsen
Original Contributions
  • 36 Downloads

Abstract

Background

Previous studies have evaluated the safety of post-operative day one (POD #1) discharge after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Few studies, however, have evaluated the impact of a standardized POD #1 discharge pathway on peri-operative outcomes. This study aims to evaluate peri-operative outcomes after implementation of an enhanced recovery pathway for RYGB patients.

Methods

Data from a prospectively maintained database identified 2,049 patients (pre-implementation n = 904; post-implementation n = 1,144) who underwent LRYGB between 2008 and 2016. The POD1 discharge pathway was implemented in July 2011. Patient demographics and outcomes before and after implementation of the POD1 pathway were compared using univariate analysis and propensity matching.

Results

A propensity-matched group of all patients (n = 714) and POD #1 candidates (n = 490) pre- and post-pathway implementation were analyzed. Successful POD #1 discharges were significantly increased after introduction of the pathway (54.3 vs 17.8%, p < 0.0001). The post-implementation groups demonstrated no differences in mortality, Emergency department (ED) visits, readmissions, reoperations, and major or minor complications.

Conclusions

Early discharge after bariatric surgery has a significant impact on the cost effectiveness of surgery, patient comfort, potential reduction of medical errors, and exposure to hospital-acquired infections. Our results demonstrate that a standardized POD #1 discharge pathway can be safely implemented and in turn, reduce hospital LOS without negatively affecting peri-operative morbidity, mortality, ED visit, readmission, or reoperation rates.

Keywords

Equivalent outcomes LRYGB Post-operative day one POD #1 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Does not apply.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Bariatric and Foregut SurgeryGeisinger Medical CenterDanvilleUSA

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