1285 Management of Acute Cholecystitis – Evaluating the Timing of Laparoscopic Cholecystectomy
M Quaunine, A Wilkins, L Chang, J Walshaw, P Lykoudis- Surgery
Abstract
Aim
Current National Institute for Health and Care Excellence Quality Standards (NICE QS104) recommend adults with Acute Cholecystitis (AC) have Early Laparoscopic Cholecystectomy (ELC) within 1 week of diagnosis. If this is not achievable, a Delayed Laparoscopic Cholecystectomy (DLC) should be performed more than 4 weeks after the initial episode. This study evaluated current practice in a tertiary hospital General Surgical department.
Method
All patients presenting with their first presentation with AC between November 2021 and March 2022 were identified from prospectively maintained surgical handovers. Patients admitted with acalculous cholecystitis, under different specialities, residing out of the area, and who self-discharged were excluded. Data was collected from electronic patient records retrospectively.
Results
81 patients were included in the study, 29 males and 52 females. The mean age of included patients was 64. 61 patients were fit for surgical intervention. 14.8% (9) of patients had an ELC within 1 week of diagnosis. 85.5% (52) of patients were planned for DLC after discharge. 13.5% (7) of DLCs were performed within 3 months of discharge and a further 50.0% (26) of DLCs were performed within 6 months of discharge. 21.2% (11) of patients were readmitted to hospital with gallstone-related presentations within 6 months of their discharge whilst awaiting DLC.
Conclusions
This study shows that national standards are currently not being achieved. This is likely due to multifactorial causes, including increasing pressures due to the pandemic. We plan to expand our data and utilise these findings to produce a business case for a regular dedicated ELC list.