264 Assessment of Timing of Cholecystectomy After Acute Mild Biliary Pancreatitis

Abstract Aim To evaluate the effectiveness of Laparoscopic Cholecystectomy Pathway for patients with mild gallstone pancreatitis at Hull Royal Infirmary. Method A retrospective closed-loop audit conducted over 7-month period (September 2023-March 2024). The audit was registered on AMAT and approvals obtained. Data were gathered and compiled into spreadsheet capturing basic demographics (age, gender, date of admission), imaging findings, surgical intervention, re-admissions, amylase levels, and timing of surgery. The audit standard: all patients with biliary pancreatitis should receive definitive gallstone management during the same hospital admission, unless a clear plan exists for treatment within two weeks of discharge. Results 46 patients met the inclusion criteria, age range:22-92 years (median age:58). Of these, 61% were male. Case stratification showed that 7 patients (11%) were unfit for surgery, 21 patients (54%) underwent surgery during the index admission, 1 patient (3%) had surgery within two weeks of discharge, 6 patients (15%) underwent delayed laparoscopic cholecystectomy, and 11 patients (28%) did not receive surgery. There were 2 mortalities (4%) during the index-admission and 1 re-admission (2%). Regarding imaging, 67% of patients had an ultrasound scan, 43% had a CT-AP, and 59% underwent MRCP. Compliance with the pathway was compared to previous audit cycles: 21.3% in 2014–2015, 33% in 2016, 83% in 2019, and 56% in the current cycle. Conclusions This reflects a decline in adherence since the last audit. The findings support the benefit of providing definitive treatment during the acute admission, which is clinically advantageous for patients by improving symptom relief, reducing re-admissions, and minimizing loss to follow-up.