1019 Timing of Laparoscopic Cholecystectomy in Patients with Acute Cholecystitis at a District General Hospital

Abstract

Abstract Aim Early laparoscopic cholecystectomy (LC) is recommended in the treatment of acute cholecystitis (AC) as a balance between reducing gallstone-related complications and surgery-related complications. NICE guidelines recommend LC within a week of diagnosis for adults with AC or to be delayed once acute episode has subsided at least 4 weeks after diagnosis. This audit aimed to assess our Trust's compliance to these recommendations. Method A retrospective analysis was conducted on all patients who received cholecystectomy following a diagnosis of acute cholecystitis between June 2021 - July 2021. After implementation, a re-audit was conducted from May 2022 - July 2022. Results A 100% compliance rate was achieved in the first cycle of the audit. Out of the 35 patient sample of newly diagnosed AC, only 16 patients underwent surgery in 2021. Out of these 16 patients, 81.3% had LC within a week and 18.7% had the procedure performed after 4 weeks. The re-audit, with a sample size of 52 patients, had an overall compliance of 96.8%. Out of the 31 patients who had surgery, 71% had surgery within a week of diagnosis and 25.8% had surgery after 4 weeks of diagnosis. Only 1 patient (3.2%) had surgery outside of the recommended timeframe as the surgery took place 9 days from diagnosis. Conclusions This audit demonstrated that our Trust has very good compliance with the guidelines where >95% of patients received their surgery within the recommended time frame. Our Trust demonstrated high rates of LC during acute admission, which aims to improve long waiting lists for elective LC.