EP 515 Does Prior Diagnosis of Gallstone Disease Influence Severity, Operative Time, and Intra-Operative Management? A Single-Centre Cohort Analysis
Zeeshan Saboor Ahmed, Emer McCarron, EiEi Khine, Manon Williams, Khurram Rais, Peter OsualaAbstract
Background
We examined whether a previously known diagnosis (PK) is associated with severity at presentation, operative time, and intra-operative management compared with first-presentation cases (SA).
Methods
Retrospective single-centre cohort. Acute pancreatitis excluded. Biliary colic/symptomatic gallstones/cholelithiasis were classified as mild disease irrespective of severity text. Primary open procedures excluded; conversions retained. Outcomes: severity (moderate/severe vs mild), operative duration (hours), IOC use, and post-operative drains. Statistics: Fisher’s exact (odds ratio, 95% CI), Welch’s t-test & Mann–Whitney U (operative time), and two-proportion tests with Wilson 95% CIs (IOC, drains). Source data: Lap Choly completed NEWS.xlsx.
Results
n=156 (PK=57, SA=99). PK patients had lower odds of moderate/severe presentation vs SA (OR 0.32, 95% CI 0.15–0.68; Fisher p=0.0031). Operative time was similar (PK 1.83 ± 0.60 h, median 1.83 vs SA 2.02 ± 0.75 h, median 1.97; t-test p=0.088, MWU p=0.215). IOC was used more often in PK (12.3%, 95% CI 6.2–23.2) than SA (4.0%, 95% CI 1.6–9.7); p=0.053. Drains were less frequent in PK (28.1%, 95% CI 18.4–40.3) vs SA (46.5%, 95% CI 36.9–56.4); p=0.024.
Conclusions
After excluding pancreatitis and classifying biliary colic/symptomatic gallstones as mild, prior diagnosis was associated with less severe presentation. Operative time did not differ meaningfully. IOC tended to be used more often in PK, whereas drains were less often used in PK. Prospective, adjusted analyses are warranted.