Laparoscopic Cholecystectomy (Lap Chole)
What is Laparoscopic Cholecystectomy?
Laparoscopic cholecystectomy or in short ‘lap chole’ refers to surgical procedure to remove the gallbladder. Gallbladder is a pear-shaped organ that sits just below the liver, and it stores digestive fluid called bile.
Why is Laparoscopic cholecystectomy done?
This surgery is usually suggested by your doctors as part of treatment of gallstones and its complications, mainly:
- Cholelithiasis: gallstones in the gallbladder that are causing symptoms such as pain.
- Choledocholithiasis: gallstones in the bile duct obstructing bile flow
- Cholecystitis: gallbladder inflammation
- Pancreatitis: pancreas inflammation
Value-Based Health Care Benefits
Patients
- Lower costs
- Better outcome
Providers
- Higher patient satisfaction rates
- Better care efficiencies
Payors
- Stronger cost controls
- Reduced risks
Society
- Reduced healthcare expenses
- Better overall health
What are Value Driven Outcomes (VDO)?
Value Driven Outcomes is a simple concept of improving care for patients with the aim to drive down costs. Its fundamental factors are based on overall patient wellness and preventive measures. Achieving this goal involves making adjustment in terms of how patients receive medical treatment, taking into consideration of overall wellness, quality of care, and preventive screenings. This ultimately results in better healthcare outcomes.
At Pantai Hospital Kuala Lumpur, we aim to make healthcare proactive rather than reactive, preventing problems from occurring before they start. In view of that, we had designed a Value Driven Outcomes (VDO) framework for Laparoscopic cholecystectomy, in which pre-set quality indicators were used to determine cost rationalisation.
Laparoscopic Cholecystectomy Quality Indicators (benchmarks)
- No conversion to open cholecystectomy
A lower rate of converting laparoscopic to open cholecystectomy indicates successful completion of the procedure without the need for a more invasive approach.
- No incident of bile duct injury
Ideally, the procedure should result in minimal to no bile duct injuries. Bile duct injuries can lead to various complications, including infection and long-term health issues. Monitoring and minimizing these incidents are critical for ensuring the safety and success of laparoscopic cholecystectomy procedures. This benchmark serves as an indicator of the surgical team's precision and adherence to best practices.
- No unplanned return to operating theatre within same episode of care
Although laparoscopic cholecystectomy is a minimally invasive and relatively safe surgery, there are possible complications that may arise. The goal is to minimize instances where patients require an unplanned return to the operating theatre during the same episode of care, highlighting the success of the initial procedure.
- No complications during laparoscopic cholecystectomy index admission
Having knowledge of laparoscopic cholecystectomy complication rates is crucial for surgeons to provide an accurate depiction of the risks and benefits associated with the procedure. Effective identification of modifiable patient and surgical risk factors can help to further reduce complications.
- No readmission for complications within 30 days post laparoscopic cholecystectomy
This metric is an essential indicator that measures patient clinical outcome and healthcare system performance. Although laparoscopic cholecystectomy is associated with limited postoperative complications, some of them could be a common cause of unplanned hospital re-admission.
- No 20 Group-Wide Serious Reportable Events (SRE) Categories reported
To monitor, evaluate and review the various serious reportable events occurring in the hospitals and to take corrective actions to address identified issues. This will help to prevent the recurrence of similar events, allowing for cross-learning and identifying key areas for improvement.
Where does Pantai Hospital Kuala Lumpur stand
Against International Benchmark
Clinical Indicators | International Benchmark | 2022 | 2023 |
---|---|---|---|
No conversion to open cholecystectomy | 92-95% | 92% | 98% |
No incident of bile duct injury | 98-99% | 100% | 99% |
No unplanned return to operating theatre within same episode of care | 99.20% | 100% | 100% |
No complications during laparoscopic cholecystectomy index admission | 92-97% | 97% | 100% |
No readmission for complications within 30 days post laparoscopic cholecystectomy | 93-96% | 97% | 100% |
No 20 Group-Wide Serious Reportable Events (SRE) Categories reported. | 100% | 100% | 100% |