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

World J Surg. 2022 Nov;46(11):2648-2658. doi: 10.1007/s00268-022-06684-w. Epub 2022 Aug 11.

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 6 days vs. 13.5 days, 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.

Trial registration: ClinicalTrials.gov NCT02810860.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholecystectomy, Laparoscopic* / adverse effects
  • Feasibility Studies
  • Humans
  • Patient Discharge
  • Patient Satisfaction
  • Telephone

Associated data

  • ClinicalTrials.gov/NCT02810860