This study found that advanced age, presentation with acute cholecystitis, and choledocholithiasis are independent risk factors for conversion from laparoscopic to open cholecystectomy.

Background: Acute appendicitis is a common surgical emergency which, even with modern diagnostic facilities, remains a challenging task for the surgeon. The variations in presentation pertaining to time, signs and symptoms can baffle even the very experienced surgeons. The aim of the study was to find out the predictive value of the Alvarado scoring system in diagnosis of acute appendicitis and its clinical applicability.

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Background: An Audit is a quality improvement process where we seeks to improve standard of care of our patients and also improve the post-operative outcomes through systematic review of our work. Objective of this study was to find out the complications and readmission after a Day surgical procedures done by a single surgeon's services. Methods:All the patients presented in the surgical Day unit at Trafford General Hospital from January 2016 to June 2016. Detail of all surgical patients admitted during the period was recorded from the theatre register. Demographic data, mode of admission, diagnosis and outcomes were recorded on a pro forma. The Operations included are Laparoscopic cholecystectomy, Hernia repair and anal canal surgery. We collected the data for readmission and any complications. Results:The total number 145, (100 males and 45 females) Age between 25-86 years. Total number of patients had laparoscopic cholecystectomy were 42 (29 female and 13 male). Three (3) patient transferred to Manchester Royal Infirmary for pain out of 42. Total number of patients had hernias 82 (57 male & 25 female). Total number of patients had hernias 21 (14 male & 7 female). No complication found, 3 (0.2%) readmission and 1 (0.68%) death with 28 days due to cardiac cause in a 85 years old male. Overall mortality was estimated as 0.68%.Conclusions: This surgical audit showed that day surgery is safe in a district hospital. Each Surgeon should do the self evaluation in a view to improve the quality of our health care system.