WP3.5 - Laparoscopic cholecystectomy: analysis of indications, time to surgery (TTS) and complications

Abstract

Abstract Aims Our aims are to establish whether current waiting times for cholecystectomy in our local trust between 01/2021 and 01/2022 are in line with NICE guidelines and compare with average national waiting times. We aim to establish the indications for cholecystectomy (CBD stones, cholecystitis, biliary colic, pancreatitis) and compare waiting times and readmission rates during the waiting period; estimate the rate of conversion to open/subtotal cholecystectomy and any subsequent complications. Methods Data collection and analysis for the period of 01/2021 – 01/2022: average waiting times, rate of conversion, indications, complications. Results 269 patients were analysed after exclusions. Of these, mean waiting time from booking to TTS for uncomplicated biliary colic was 63.26 days. The median TTS from booking was 14 days for hot gallbladders. Of patients diagnosed as biliary colic, the TTS following an acute hospital admission was 63.26 days. Similarly, the patients referred via GP to the outpatient surgical clinic for the same diagnosis was 78.88 days. 5 patients who were referred routinely via GP to the outpatient surgical clinic had complications requiring an acute surgical admission during the waiting period. The rate of conversion to open was 0% during the 1-year period. 2 patients had subtotal cholecystectomies, one of which had persistent bile leak managed with drains and subsequent ERCP. Conclusion The median TTS for hot gallbladder is in line with national standard. There is a tendency to opt for subtotal cholecystectomy as bail out as compared to the previous years.