SP 7.05 From Generalisation to Specialisation: Upper Gastrointestinal Surgery Outcomes After Splitting the Surgical Take
Yacoub Majdoubeh, Jennifer Tempany, Ahmed Marzouk, Mohamed Elnagar, Tameem Ibraheem, Ihab HraishawiAbstract
Aims
In September 2025, the General Surgery on-call service at a District General Hospital in the United Kingdom transitioned from a single general surgical take to two subspecialty teams: Upper Gastrointestinal (UGI) and Colorectal Surgery. This audit aims to assess whether this change in service structure has impacted patient outcomes and key performance indicators for admitted UGI patients.
Methods
A retrospective review of patient data from electronic records was conducted before and after implementation of the split and specialised take. The pre-specialisation period was from 01/06/2025 to 15/06/2025. The post-specialisation period was from 19/11/2025 to 09/12/2025.
Results
A total of 66 patients were included. Following the specialisation of the take, several outcome measures and key performance indicators significantly improved. All UGI operations were performed by UGI surgeons, compared to 75% prior to specialisation. UGI post-operative complication rates decreased from 12.5% to 0%. In UGI patients who needed operative intervention, the operative rate increased to 77% during the index admission (up from 58%), including 100% of surgically fit gallstone related acute pancreatitis patients getting a cholecystectomy during their index admission, compared to 33% previously; the average post-operative length of stay decreased from 2.75 days to 2.1 days.
Conclusions
This audit demonstrates that the specialisation of the surgical take was associated with significant improvements in UGI patient outcomes and key performance indicators. These findings support the adoption of subspecialty-based on-call services and may serve as a model for other hospitals in the region considering a move towards specialisation of the emergency take.