EP 534 Evaluation of a Newly Introduced Hot List Laparoscopic Cholecystectomy Service at a Busy District General Hospital Amidst the Established and Increasing Burden of Biliary Disease
Catherine Simister, Anisha Tolat, Abanoub Fidal, Makhosini Mlotshwa, Anupam Dixit, Paul MackenzieAbstract
Aims
Acute gallstone disease places a significant burden on healthcare services. This study evaluated a hot laparoscopic cholecystectomy service at a DGH against NICE guidelines to identify ways to improve service delivery.
Methods
Patients undergoing hot laparoscopic cholecystectomies (LC) between 26th June 2025 and 12th January 2026 were identified retrospectively from operating lists. Demographic, admission, operative, and outcome data were collected, and analysed statically and descriptively.
Results
36 patients underwent a LC in the specified period by two surgeons on 20 hot lists with complete data for 34 patients; 26 LCs were performed on CEPOD during this period. 85% of LCs occurred on afternoon lists. Patients were mostly female (81%) with a mean age of 49.1 years (95% CI 43.0 to 55.3). Cholecystitis was the commonest indication (n=20). 19 patients had previously presented with biliary disease (mean 1.74, maximum 6 presentations). LCs occurred a mean of 5.50 days after diagnosis (95% CI 3.35 to 7.65). 39% (n=14) were already inpatients, and 61% (n=22) were day case admissions. Mean procedure time was 81.1 minutes (95% CI 71.0 to 91.12). Mean postoperative length of stay was 1.77 days (95% CI 0.79 to 2.75) with 38.9% (n=14) discharged the same day. Complications occurred in 22% of patients, with two readmissions.
Conclusions
The hot LC service met NICE standards, however, over half of patients required overnight stay, and several had multiple prior biliary presentations. Comparable numbers of LCs on emergency lists suggests insufficient hot list capacity, indicating a need to further optimise the service.