SP9.5 Outcomes after Emergency Cholecystectomy: A Multicentre Retrospective Cohort Study

Abstract

Abstract Aims Gallstone disease affects 10-15% of the UK population and represents a significant proportion of emergency general surgical admissions. Consensus international guidelines recommend cholecystectomy for all stable patients within 7 days of admission for emergency biliary pathology. This study sought to evaluate the outcomes of emergency cholecystectomy at a regional level over a 5 year period. Methods Retrospective multicentre study of all patients undergoing cholecystectomy at 4 acute hospitals in East London, UK, covering a population of 2.9 million, between 2016 and 2021. All previous hospital attendances with biliary pathology were retrieved to 2010 from prospectively maintained electronic patient records. The primary outcomes were time to surgery (TTS) from index attendance and total length of stay (TLOS) stratified by timing of surgery. Multivariable linear regression was used to identify independent predictors of TTS and TLOS. Results 2056 patients were identified. 1786 (86.9%) underwent elective cholecystectomy and 270 (13.1%) cholecystectomy during an emergency admission. Median TTS was 108.3 days overall with 5.8 days for emergency cholecystectomy, median TLOS was 5.0 days overall and 7.6 days for emergency cholecystectomy. After adjustment with linear regression, emergency cholecystectomy reduced TTS by 112.3 days (95% CI 140.2-84.4), whilst each year of age increased TTS by 0.80 days and male gender was associated with 38.1 days greater TTS. For TLOS, emergency cholecystectomy was associated with an increase in admission time by 3.54 days (95% CI 2.04-5.03). Conclusions Emergency cholecystectomy significantly reduces time to cholecystectomy from index attendance with biliary pathology at the cost of increased overall time admitted.