EP 504 The Radiological Burden from Acute Non-Operative Management of Symptomatic Gallstones

Aims

Due to insufficient resources, our institution largely employs a non-operative approach to acute gallstone presentations. The aim of this service review was to establish the resource implications of this approach from a radiological perspective.

Methods

13 codes were used to identify symptomatic gallstone patients admitted to general surgery in March 2024. The first presentation of the patient's gallstones was identified, the timeframe of this was 26/04/2017 – 09/05/2024. Radiological data was extracted for all patients for the index admission and/or subsequent admissions. Data was analysed in Excel.

Results

250 records were identified. Following exclusion, 72 patients were identified. ImagingIndex admissionComputed Tomography (CT)66.7% (48/72)Magnetic Resonance Cholangiopancreatography (MRCP)47.2% (34/72)Ultrasound (U/S)45.8% (33/72)

Multiple scans were performed in 33/72 (45.8%) – (CT + MRCP in 14, CT + U/S in 10 and CT + MRCP + U/S in 9).

A further 55 readmissions occurred from 26/72 (36%) patients resulting in a further 30/55 (54.5%) CT 25/55 (45.5%) MRCP and 33/55 (60.0%) U/S scans.

Conclusions

The radiological burden on index and subsequent readmissions is considerable, with a high number of CT scans performed. Rationalising the diagnostic pathway and developing an acute/expedited cholecystectomy service may have substantial cost savings which would help support the development of business cases.