Safety and efficacy of same-day discharge after laparoscopic appendicectomy: an Australian first prospective cohort study

Background: Same-day discharge (SDD) following laparoscopic appendicectomy (LA) is internationally recognised as safe and cost-efficient, but its routine implementation in Australia remains limited. This study aimed to evaluate the safety, feasibility, and outcomes of an SDD protocol for LA within an Australian healthcare context. Methods: A prospective quality control study was conducted at Campbelltown Hospital from 1 August 2024 to 1 September 2025, following the introduction of an SDD protocol. We aimed to assess the feasibility and safety of SDD, measured by the proportion of successful SDD LA and day-case appendicectomy (DCA), and 30-day re-presentation and readmission rates, respectively. Results: Of 336 appendicectomies performed during the study period, 180 patients were considered for the SDD pathway and 82 met inclusion criteria. Successful SDD was achieved in 70.7% (n = 58), and DCA in 81.7% (n = 67). Multivariable analysis identified later operation start time (OR 1.93 per hour delay, p < 0.001) and postoperative Clavien–Dindo (CDC) Grade I (OR 32.9, p < 0.001) and Grade II complications (OR 26.5, p < 0.001) as independent predictors of SDD failure. 6.1% (n = 5) re-presented in 30 days, and one (1.2%) was readmitted. Patient experience was favourable: overall satisfaction was 83% among respondents (65%), and 70% preferred SDD. Conclusion: SDD following LA is safe and feasible in the Australian setting. Pathway failure was primarily driven by later operation timing and postoperative complications, highlighting the importance of careful patient selection and perioperative optimisation.