1158 Outcome of Hot Laparoscopic Cholecystectomy Service Evaluation in Morriston Hospital, SBUHB

Abstract

Abstract Aim Symptomatic Gall Bladder disease is a common general surgery presentation. NICE guidelines recommend performing laparoscopic cholecystectomy (within 1 week of diagnosis) for patients with acute cholecystitis. Patients who had gall stone pancreatitis should have laparoscopic cholecystectomy on the index admission. Historically poor availability of theatre slots has resulted in unacceptable delays in our health board. The objective of this study was to evaluate adherence to these recommendations before and after an intervention to improve theatre access. Method A retrospective study of inpatient laparoscopic cholecystectomies between 20/06/2022 and 28/11/2022 was undertaken in Morriston Hospital. On 20/09/2022, dedicated theatre lists for laparoscopic cholecystectomy were moved from afternoon sessions to morning or all-day sessions with the intention of minimising delays. Baseline patient and operative details were captured from electronic health records. Outcomes were adherence to recommendations from NICE and time to procedure from booking and number of procedures done before and after the intervention. Result 85 patients were included (42 patients before (Group 1) and 43 after the intervention (Group 2). 100% of patient from group 1 received cholecystectomy within a week of booking compared to 86% from group 2 (P = 0.09). Mean time to procedure was 2.5 days and 3.5 days for group 1 and group 2 respectively (P = 0.076). 3.5 patients received cholecystectomy per week in group 1 as compared to 4.4 in group 2. Conclusions Changing the timing of Theatre lists from Afternoon to Morning/all day resulted in more patients receiving cholecystectomies without compromising time from booking to procedure