EP 434 Variation in Cholecystostomy Tube Management Between Upper and Lower GI Surgical Teams
Hannah Durband, Emily Robinson, Amelia Hardy, Arin SahaAbstract
Aims
To compare post-procedure management of cholecystostomy tubes for acute cholecystitis between Upper GI (UGI) and Lower GI (LGI) surgical teams in a UK district general hospital.
Methods
All patients undergoing cholecystostomy tube insertion for acute cholecystitis during 2025 were reviewed retrospectively. Patients were grouped according to responsible specialty. Outcomes included discharge planning, follow-up arrangements, use of tubography, tube-related complications and time to tube removal.
Results
Sixteen patients underwent cholecystostomy tube insertion, which represented <0.1% of all acute biliary admissions; five were managed by UGI teams and eleven by LGI teams, with three LGI patients subsequently transferred to UGI care. Patients under UGI care were more likely to have a defined plan for tube management and earlier tube removal. Median time to tube removal was 5.6 weeks for UGI patients compared with 11 weeks for LGI patients. Fewer LGI-managed patients had tubography or formal outpatient follow-up arranged at discharge. Tube displacement occurred in six patients overall. Considerable variation was observed in documentation, follow-up and timing of intervention between specialties.
Conclusions
Significant inter-specialty variation exists in the management of cholecystostomy tubes following acute cholecystitis. Differences in follow-up planning and tube dwell time may impact patient safety and experience. Standardised guidance and clearer ownership of post-procedure care may reduce variability and improve outcomes. These findings are likely representative of practice in other non-specialist centres and suggest potential benefits of sub-specialty emergency rotas for these conditions and treatment.