177 Impact of Covid Pandemic on Cholecystectomy Waiting Lists in NHS Highland: Lessons and Opportunities

Aims

The standard waiting time for elective surgery is 18 weeks. However, it continues to face pressure. We aimed to look at:

Methods

Retrospective data of patients listed for a cholecystectomy throughout the health board from April 2019-June 2022 were collected using electronic records. Patients removed from the list were excluded. Data was collected on patient demographics, hospital listed/performed, waiting list length, surgical approach and post-operative outcomes.

Results

278 patients were included. 79% operations were listed centrally with 52% performed there. 72% were female and 28% male. The average age was 53.6 years (22-91).

Of those listed 45% underwent surgery. The average waiting time was 106 days overall (5-1024), 110.5 in 2020, 156 in 2021, 57.5 in 2022, 78% being performed within target. 98.4% were laparoscopic and 1.6% converted. 88% of operations were elective and 12% emergency. 1 patient had malignancy on pathology. 15 patients had complications with 3 bile leaks (2.4%).

22 patients were admitted whilst waiting for a total of 36 days, costing an estimated £14,400. 64% received an emergency operation during admission, all which were performed centrally (p=<0.05)

Length of stay was shorter at C (p=<0.05) and equivalent at B. Complications were lower at C (7.7%) and B (11%) compared to centrally (13%).

Conclusions

Patients are waiting longer for cholecystectomies with increased financial burden. Complications rates have increased, especially bile leaks which needs to be investigated further. Rural hospitals can be safely used to alleviate pressures.