152 Improving Imaging in Acute Pancreatitis

Abstract

Abstract Aim In the UK it is not a current practice to perform early (< 3 days) CT for detection and staging of severe cases of acute pancreatitis. Findings of pancreatic necrosis, fat stranding and intraperitoneal fluid should be included in the CT scan report as they are important prognostic factors. Furthermore, radiological facilities should be available to permit US examination of the gallbladder <24 hours of the diagnosis. The aim was to meet 95% for all standards. Method Retrospective baseline data were obtained for 83 patients presented with acute pancreatitis between January 2020 and February 2021. Several interventions were implemented including educational posters, emails and lectures to general surgeons and radiologists. Re-auditing was conducted between May and August 2021 to measure the effectiveness of these interventions. Results Baseline showed low compliance to standards, and 62% of presented patients underwent early CT (< 3 days). Only 78% received US scan within 24 hours of admission. Second cycle showed increased adherence to NICE guidelines with 56% of patients had CT scan in optimal timing. Reports of CT scans showed minimal improvement in terms of including the prognostic factors. US examination of gall bladder improved with 83% of patients diagnosed with acute pancreatitis. Conclusions Early CT may underestimate final severity of acute pancreatitis. Low adherence to guidelines was noticed in the first audit cycle which was increased after the interventions. Further interventions and auditing will be needed.