ThP5.11 - Reducing Gallstone Related Patient Episodes Through Index Admission Management: A Multicentre Retrospective Study

Abstract Aim Gallstones represent a significant portion of acute general surgical admissions, with widespread management practices across the UK. Our objective was to assess the effects of implementing proactive management strategies for symptomatic gallstones and their complications on admissions related to gallstone. Methods A retrospective multicentre study of three acute general surgical units within a single health board with similar population coverage between 2014 and 2018. In site A, the standard of care was definitive management of gallstone disease in the index admission; whereas in site B & C this was not the case. All gallstone related presentations were included. The data was extracted from the health board coding data. Number of biliary related admissions compared between the three sites. Results 3,790 episodes were identified. Biliary colic was the most common (54.9%) reason for presentation followed by acute cholecystitis (22.7%), acute pancreatitis (16.2%) and ascending cholangitis (6.2%). For biliary colic: site A had 361 presentations, site B had 853 presentations and site C had 867 presentations. The occurrences of more than one admission were 22.7%, 36.3%, and 42.3% for Site A, B, and C, respectively. Overall, site A had 796 biliary presentations; compared to 1497 each at site B and C. Conclusion Implementing definitive surgical interventions during the index admission for biliary-related cases offers a substantial reduction in re-admission rates, leading to an overall decrease in hospital attendance. This not only yields significant cost benefits for the health board but also enhances the quality of life for patients.