ThTP1.11 Closed Loop Audit on The Timing of Hot Gallbladder Surgery

Abstract

Abstract Introduction Almost 70,000 cholecystectomies are performed each year in the United Kingdom (UK). The Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS) 2016 and The National Institute for Health and Care Excellence (NICE) 2021 Guidelines on “Gallstone disease” recommend performing a Laparoscopic Cholecystectomy (LC) within 7 days of admission for hot gallbladder. We aimed to establish if guidelines were being met at a tertiary hepatobiliary unit in Oxford. Method Two cycles of the audit were completed using a retrospective cohort design. The first cycle of the audit was completed between January 2019 – August 2020 (n=466) to include patients that had a LC for a hot gallbladder. An intervention included an educational teaching session within the department and posters distributed of the guidelines. The second cycle of the audit was completed during November 2022 (n=50). Results In the second cycle, more patients had a LC within 3 days of admission (36% vs 24.7%), with the average waiting time from admission to a LC being 6.4 days. However, less patients had their LC within 7 days of admission in the second cycle (68% vs 75.3). The most common cause for delayed LC was waiting times for ERCP/MRCP and theatre availability. Conclusion An improvement was found in the number of LC's performed within 3 days of admission in the second audit cycle. We are, however, still not meeting the AUGIS and NICE guidelines on performing a LC within 7 days of admission. Future work will look at Intra-operative laser breakdown of gallstones to reduce waiting times.