14 NICE CG188; Hot Gall Bladder Pathway in Emergency General Surgery - Are We Following the Guidelines?

Abstract

Abstract Aim 1 - To compare the current standard of practice to existing guidelines and to make appropriate changes. 2 - To set a clear pathway for referring patients to the ‘hot laparoscopic cholecystectomy’ pathway. 3 - Avoid inappropriate booking for laparoscopic Cholecystectomy for patients who are not fulfilling the criteria of Hot Gall Bladder Pathway. 4 - Avoid unnecessary delay in performing Laparoscopic Cholecystectomy in patient with Acute Cholecystitis and mild Biliary Pancreatitis. Method It was a retrospective audit of all the patients who underwent Laparoscopic Cholecystectomy through Hot Gall Bladder Pathway between 1st February 2019 to 1st March 2020. We screened a total of 134 patients who had been included in this pathway, 36 patient excluded. 1- Acute cholecystitis with no associated organ dysfunction 63 patients 2- Mild Acute Biliary Pancreatitis 35 patients Results Mild Acute Biliary Pancreatitis who underwent Laparoscopic Cholecystectomy within index admission or within 2 weeks of diagnosis 69 % (25/35). Acute cholecystitis with no associated organ dysfunction (mild or moderate; Tokyo guideline grade I or II) who underwent Laparoscopic Cholecystectomy within week of diagnosis 68.2 % (43/63). Conclusions