P-BN14 Differences in rate of complications between emergency and elective laparoscopic cholecystectomy at district general hospital

Abstract

Abstract Background Current NICE guidelines recommend healthy low risk patients who present with acute biliary disease should be offered laparoscopic cholecystectomy on the same index admission. The increased complexity of the acute operations may impact on the operative complication rates; hence the aim of this study is to evaluate and compare the operative complication rates between elective and emergency laparoscopic cholecystectomies and additionally to assess the difference in surgical techniques comparing complete cholecystectomy versus subtotal versus open procedures. Methods Retrospectively, data was collected from emergency and elective Laparoscopic Cholecystectomies completed in the period 01/01/2021-01/06/2021 at the Queen Elizabeth Hospital Gateshead. The data set was gathered from an electronic theatre database and the individual cases were sub-analyzed further by delving into the electronic patient records database. Statistical analysis done by using Excel 2010. Results The average age of both groups was 50 years. There wasn’t a statistical significance on the rate of complication between the elective Vs emergency cholecystectomies (Elective 2%, Emergency 9% P = 0.17). Out of 42 Elective procedures, 4 had Sub-total cholecystectomy Vs 3 out of 42 patients on the emergency group who had Subtotal cholecystectomy (9% Vs 7%), implying there was no significant difference noted between the two groups. Average hospital stays was 5.6 days for the acute presentation with biliary disease Vs 0.14 days on the planned elective group. 2% of the elective group were noted to have a surgical drain inserted during the operation; whilst the emergency cohort had a slightly higher rate at 5%. Conclusions Overall there was no significant difference noted between the surgical complications arising in emergency cholecystectomy compared to planned surgeries. In addition to this the data also suggests that there is negligible difference in the rates of sub-total cholecystectomies in both cohorts.