OGBN P40 Laparoscopic Cholecystectomy waiting list: morbidities and cost

Abstract

Abstract Background Gallstone Disease refers to the presence of stones in the gallbladder or common bile duct, which can lead to symptoms and complications. Around 15% of adults are affected by this condition, but only 20% of them experience symptoms. The severity of symptoms can range from mild and nonspecific to intense pain and complications. Treatment options vary and can include conservative or medical approaches, endoscopic procedures, or surgical interventions. Cholecystectomy is considered the gold standard for managing symptomatic gallstones. In the UK, Approximately 66,660 surgeries conducted annually in the UK (61,220 laparoscopically), which cost around £111.6 million per year. Methods A retrospective analysis was conducted on the patients listed for Laparoscopic Cholecystectomy in the General Surgery department of Aberdeen Royal Infirmary. The study covered the period from January 1, 2019, to June 30, 2022, focusing on the occurrence of morbidities or complications, such as re-admissions and visits to the emergency department (ED), as well as the associated costs. Trakcare documentation was utilized for data collection. The data was collected in November 2022. The analysis involved identifying patients and their demographics from the Master Waitlist. Complications, hospital readmissions, and emergency surgeries were analyzed using SPSS. Results Out of 857 patients on the waitlist, the average age was 54.8 years, with females comprising 69.2%. The mean wait time was 15.8 months (maximum: 45 months). Around 8.2% re-presented to the ED, mostly due to biliary colic, with a mean of 3.7 visits (maximum: 8). SAC clinic visits were needed for 4.8% of patients. Hospital readmission occurred for 4.3% with an average stay of 17 days. Complications affected 11.4% of patients, including colic, cholecystitis, Choledocolithiasis, pancreatitis, Cholangitis, perforated gallbladder, Mirrizi Syndrome, and Fistula. Interventions were required for 7.2% of patients. Only 7% underwent cholecystectomy, with 8 being emergency cases. Conclusions The prevalence of gallstone disease is high, and patients who experience a delay in their surgical operation often suffer from various morbidities. These complications not only impact the well-being of the individuals but also create a financial burden for healthcare providers. To address this issue, the implementation of an urgent or hot Gallbladder list could potentially offer a solution. By prioritizing patients requiring immediate attention, this approach aims to reduce the adverse effects associated with prolonged waiting times and improve both patient outcomes and the overall efficiency of the healthcare system.