243 Timeliness of Laparoscopic Cholecystectomy in Acute Cholecystitis: An Audit of Compliance and Associated Morbidity

Abstract Aim This study aimed to assess local adherence to guidelines set out by the National Institute for Health and Care Excellence (NICE) and the British Benign Upper Gastrointestinal Surgical Society (BBUGSS): offering early laparoscopic cholecystectomy (LC) within 1 week of an acute cholecystitis diagnosis to minimise complications (CG188), and morbidity post-LC of <10%. Method Medical records of 61 patients, who underwent LC for acute cholecystitis at a district general hospital between May 2023 and February 2025, were reviewed for admission dates, operation dates, and postoperative complications, which were graded using the Clavien-Dindo classification. Results Of the 61 LCs, none were performed within 1 week of diagnosis with acute cholecystitis, and were elective instead, many of which were day-cases. One patient underwent a percutaneous cholecystectomy, and later a LC. 26 patients experienced grade II and IIIa complications (43%) following LC. Conclusions No patients underwent a LC within 1 week of diagnosis with acute cholecystitis, failing to meet NICE CG188 guidance. Elective LC was performed instead. Delayed surgery may have been due to patients’ comorbidities, severity of inflammation, limited theatre capacity, or surgeon availability. Morbidity post-LC exceeded the <10% BBUGSS benchmark, potentially linked to delayed intervention or patients’ pre-existing comorbidities. Future work should focus on identifying and addressing such barriers to early surgery and evaluate interventions to improve compliance and patient outcomes.