267 An Audit of The Management of Acute Cholecystitis At ELHT

Abstract

Abstract Aim Acute cholecystitis is a common condition on the surgical take. The evidence shows that the optimal approach is with early laparoscopic cholecystectomy in patients suitable for surgery (Cao, 2015). The aim of this audit was to assess the adherence of the surgical department at ELHT to NICE guidance CG 188 in the management of patients with gallstone disease (NICE, 2014): Offer early laparoscopic cholecystectomy (within 1 week of diagnosis) for acute cholecystitis. Method Retrospective study of all patients with image confirmed diagnosis of acute cholecystitis between 25th January to 1st October 2018. Any unsuitable candidates for surgery were not counted. Results The case notes of 153 patients were reviewed. 109 were included in this study, as the other patients were not likely to be offered surgery due to their comorbidities. Of these 109 patients, 51 (47%) had a laparoscopic cholecystectomy within a week of diagnosis. Conclusions ELHT is not meeting the target of management within 7 days for over half of patients. The modifiable reasons for not meeting the targeted treatment time are a lack of capacity in theatre and Consultants’ decisions to delay treatment. The addition of a dedicated hot gallbladder theatre list can increase the numbers treated within the target time.