ThTP5.1 Laparoscopic cholecystectomy on index admission – are we following AUGIS guidelines?

Abstract

Abstract Background Laparoscopic cholecystectomy is the gold standard in management of acute cholecystitis, biliary colic and gallstone induced pancreatitis. AUGIS has produced guidelines recommending optimal timing during index presentation for surgery. Aim To identify if our local acute surgical unit was following AUGIS guideline recommendations and performing laparoscopic cholecystectomy on index admission for recurrent/ongoing biliary colic, mild gallstone pancreatitis and for acute cholecystitis within 72 hours of onset of symptoms. Methods Prospective review of surgical patients admitted to DGH in Northern Ireland with acute cholecystitis, biliary colic and gallstone pancreatitis over six-month period between April and September 2021. Results 103 patients were admitted during 6 months with gallstone disease. Of these, only 20 underwent inpatient lap cholecystectomy during their admission. 21 patients were deemed unfit for surgery and 3 declined surgery. 10 patients with acute cholecystitis had surgery; only 4 had symptom onset within 72 hours as recommended. Conclusion This unit was not following AUGIS recommendations on the timing of laparoscopic cholecystectomy for patients presenting with gallstone disease. During this data collection a pathway was started for day case laparoscopic cholecystectomy at a satellite site to help expedite patients who were unable to have their operation as inpatient.