Safety of Same-Day Discharge After Laparoscopic Sleeve Gastrectomy: Propensity-Score Matched Analysis of the MBSAQIP registry

Abstract Background Information on the safety of outpatient sleeve gastrectomy is sparse. Objectives This study aimed to assess the safety of sleeve gastrectomy as a day case surgery. Setting University health network, United States. Methods Patients who underwent primary sleeve gastrectomy were identified in the 2015-2017 MBSAQIP database. Day case surgery procedure was defined as having a hospital length of stay of 0 days. Day case surgery patients were matched with inpatient controls using propensity score matching. The primary outcome was 30-day mortality. Results A total of 271,658 sleeve gastrectomy patients met the inclusion criteria. Of these, only 7,825 (2.88 %) were day case surgery procedures. There was no mortality in the group. Day case surgery, as compared with inpatient sleeve gastrectomy, was associated with a similar risk of a leak (0.56% vs. 0.40%; relative risk [RR], 1.419; 95% confidence interval [CI], 0.896 to 2.245, p=0.133), bleeding (0.38% vs. 0.31%; RR, 1.250; 95%CI, 0.731 to 2.138 , p=0.414), 30-day reoperation (0.81% vs. 0.56%; RR, 1.432; 95%CI, 0.975 to 2.104, p=0.066) and 30-day morbidity (1.15% vs. 1.01%; RR, 1.139; 95%CI, 0.842 to 1.541 , p=0.397). Outpatients’ SG increased the risk for 30-day readmission (3.35% vs. 2.79%; RR, 1.202; 95%CI, 1.009 to 1.432 , p=0.039). Conclusions Sleeve gastrectomy in the outpatient setting as a day case surgery was associated with no mortality and no statistically significant risk of reoperation, leakage, or bleeding when compared to patients admitted to inpatient units. The readmission rate was higher in the day-case surgery group.