How safe is same-day discharge after laparoscopic sleeve gastrectomy?

Background: Laparoscopic sleeve gastrectomy (LSG) is associated with low morbidity and mortality and a short length of stay. Studies on the safety of same-day discharge after LSG are limited. Objective: To compare outcomes between same-day versus first-postoperative-day (POD1) discharge after LSG. Setting: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database. Methods: The 2015 to 2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was analyzed for elective LSG cases with same-day or POD! discharge. Open, revisional, and converted cases were excluded. Multivariate analysis was performed to compare adjusted 30 -day mortality, morbidity, readmission, and reoperation for same -day versus POD1 discharge. Results: We examined 85,321 LSG cases, including 4728 same -day discharges and 80,593 POD1 discharges. Compared with POD1 discharges, same -day discharges were associated with higher overall morbidity (1.31% versus.84%, respectively; adjusted odds ratio [AOR] 1.72; P =.0002), a higher readmission rate (2.14% versus 1.64%, respectively; AOR 1.40; P=0.0034), and a higher reoperation rate (.61% versus.27%, respectively; AOR 2.35; P <.0001). There was no difference in mortality (.08% versus.04%, respectively; AOR 2.62; P =.0923). Conclusion: Same-day discharge after LSG is associated with increased complications, readmissions, and reoperations compared with POD1 discharge. Further studies are needed to examine objective criteria for safe same -day discharge after LSG. (C) 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.