TPTh 2.05 Postoperative Length of Stay and Barriers to Discharge Following Laparoscopic Appendicectomy: A Retrospective Analysis

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Abstract Aim To evaluate factors associated with prolonged postoperative length of stay (LOS) following laparoscopic appendicectomy and to identify modifiable barriers to timely discharge. Methods A retrospective analysis was conducted of 220 laparoscopic appendicectomies performed between June and December 2025 at a single UK tertiary centre. Data were extracted from the electronic patient record. Patients were compared by postoperative LOS into <24 hours and >24 hours groups. Outcomes were analysed according to appendicitis severity (complicated versus uncomplicated), patient demographics, and documented reasons for delayed discharge among patients with LOS >24 hours. Results Of 220 patients, 136 (62%) were discharged within 24 hours, while 84 (38%) had LOS >24 hours. Discharge within 24 hours was not associated with increased reattendance or readmission. Among patients with prolonged LOS, 38% experienced delays due to logistical or administrative factors, or had no identifiable documented reason for continued admission. Use of postoperative intravenous antibiotics was variable between operating surgeons. Complicated appendicitis (perforation, necrosis, or abscess) was associated with significantly longer LOS; however, expedited discharge in these patients remained safe. No significant association with longer LOS was identified for age, comorbidity, preoperative waiting time, biochemical markers, or pyrexia. Conclusion Expedited discharge following laparoscopic appendicectomy is safe and achievable for the majority of patients. Prolonged LOS is frequently driven by non-clinical factors and variation in postoperative management. Introduction of a standardised postoperative care pathway represents a clear target for quality improvement, with potential to reduce unnecessary inpatient stay while also improving patient flow and resource utilisation.