A large retrospective study from a tertiary referral center in New Zealand evaluated the safety and feasibility of same-day discharge following laparoscopic appendicectomy for uncomplicated acute appendicitis. The analysis included 2,258 adult patients treated between 2015 and 2024, making it one of the largest real-world assessments of ambulatory appendicectomy practice.

Among the study population, 213 patients (9.4%) were discharged on the same day as surgery, while the majority remained hospitalized for one or two postoperative nights. Despite the shorter stay, clinical outcomes were highly reassuring.

Key Findings

Patients discharged on the same day experienced:

No increase in major postoperative complications.
No increase in 30-day hospital readmission.
Comparable overall recovery outcomes.

Major complications (Clavien-Dindo Grade III or higher) occurred in:

0% of same-day discharge patients.
0.6% of patients admitted overnight.

Thirty-day readmission rates were virtually identical:

7.0% in the same-day discharge group.
6.7% in the overnight admission group.

An important operational finding was the influence of operating room timing. Patients undergoing surgery during morning operating lists were significantly more likely to achieve successful same-day discharge, suggesting that hospital workflow, discharge planning, and theatre scheduling are critical components of an effective ambulatory surgery pathway.

Practical Considerations

The authors acknowledge that this was not a randomized trial and that selection bias likely influenced results. Patients chosen for same-day discharge were generally those considered clinically stable and low risk by their treating teams.

Successful same-day discharge depended on:

Uncomplicated appendicitis.
Stable postoperative observations.
Effective pain control.
Minimal nausea or vomiting.
Ability to tolerate oral intake.
Adequate home support.
Clear discharge instructions and return precautions.

Clinical Relevance

Laparoscopic appendicectomy remains one of the most frequently performed emergency surgical procedures worldwide. As healthcare systems continue to face increasing bed occupancy and resource pressures, this study supports the development of structured ambulatory appendicectomy pathways for carefully selected patients.

The findings suggest that with standardized protocols, early operative access, coordinated discharge planning, and reliable follow-up systems, same-day discharge can safely reduce hospital utilization without compromising patient outcomes. For emergency laparoscopic surgeons, the message is clear: patient selection remains essential, but hospital organization and pathway design may be equally important determinants of success.

Source: PubMed Study