Effect of pre-operative opioid exposure on surgical outcomes in elective laparoscopic cholecystectomy

Abstract

Background: The effects of varying levels of pre-operative opioids on post-operative outcomes following elective laparoscopic cholecystectomy is largely unknown.

Methods: Patients who underwent elective laparoscopic cholecystectomy from 2012 to 2019 were reviewed and categorized by the number of outpatient opioid prescriptions received in the 90 days preceding surgery: none (Naïve), one (1 Rx), two (2 Rx), or three or more (Chronic). Operative time, hospital length of stay, and 30-day readmission rate were analyzed.

Results: Of the 11911 patients identified, 2958 (24.8%) used opioids pre-operatively. Among patients with an overnight admission, the Naïve, 1 Rx, and 2 Rx cohorts had a shorter length of stay compared to the Chronic cohort. The Naïve group had the lowest 30-day readmission rate (5.0%) followed by the 1 Rx (5.9%), 2 Rx and Chronic groups (9.1% and 8.7%, respectively) (p < 0.001).

Conclusions: Prevalence of pre-operative opioid use is high and warrants surgeon assessment to minimize adverse post-operative outcomes.

Keywords: Cholecystectomy; Elective; Laparoscopic; Opioid; Outcomes; Pre-operative.