351 Delaying the Inevitable: How Prolonged Waits for Cholecystectomy Complicate Clinical Presentation and Strain Health System

Abstract Aim This study aimed to evaluate the clinical outcomes and implications of prolonged waiting times for elective cholecystectomy, focusing on complication rates, healthcare utilization, and the association with wait duration. Method A retrospective analysis was conducted on 697 patients listed for elective cholecystectomy. Data were collected on the duration of waiting time, incidence of gallstone-related complications, hospital admissions, and the need for additional diagnostic or interventional procedures. Statistical analysis was performed using the chi-square test to assess associations between waiting time and clinical outcomes, with significance set at p < 0.05. Results The waiting time ranged from 0 to 2943 days, with a mean of 801.3 days. A total of 94.7% of patients developed complications while awaiting surgery. The most frequent complications were biliary colic (77.6%), acute cholecystitis (43.2%), obstructive jaundice (22.7%), and gallstone pancreatitis (7.6%). Of those with complications, 64% required hospital admission. A significant association was observed between longer waiting times and the need for hospital admission (p = 0.001), ultrasound (p = 0.001), MRCP (p = 0.003), and ERCP (p = 0.001). No significant association was found between waiting time and overall complication rate (p = 0.297) or CT utilization (p = 1.000). Conclusions Prolonged waiting for cholecystectomy is associated with a high burden of complications and increased healthcare resource utilization, particularly hospital admissions and advanced imaging or interventions. Strategies to reduce surgical waiting times may significantly improve patient outcomes and decrease system strain.