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)

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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 IndicatorsInternational Benchmark20222023
No conversion to open cholecystectomy92-95%92%98%
No incident of bile duct injury98-99%100%99%
No unplanned return to operating theatre within same episode of care99.20%100%100%
No complications during laparoscopic cholecystectomy index admission92-97%97%100%
No readmission for complications within 30 days post laparoscopic cholecystectomy93-96%97%100%
No 20 Group-Wide Serious Reportable Events (SRE) Categories reported.100%100%100%
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