144 The Burden of Harm of a Long Wait Time for Laparoscopic Cholecystectomy; the Experience of a National Referral Centre

Abstract Aim Waiting times for surgery have risen since 2020. At present, almost 25% of patients awaiting surgery in Scotland have been waiting over one year, and just over 3% waiting over 3 years. Our aim was to investigate whether patients with longer wait times for laparoscopic cholecystectomy are more likely to experience peri-operative complications up to 30 days post-operatively. Method Retrospective analysis of 177 patients undergoing laparoscopic cholecystectomy at a national referral centre for Scotland was performed over a period of one year. Patients were analysed in groups of those waiting 0 – 100, 101- 200, 201 – 300, 301 – 500, 501 – 700, 701 – 900 and 901 – 2000 days respectively. Results Median age was 56 years and median number of days from decision to place the patient on the waiting list to the date of their surgery was 515 days (35 – 1961). Overall complication rate was low, at 3.4%. Two had complications <3 clavien-dindo classification, 3 had their procedure abandoned after laparoscopy and 1 patient had a subtotal laparoscopic cholecystectomy. Patients waiting up to 200 days did not experience any complications, and complications were seen in every cohort waiting beyond 200 days. At 10%, the patients who experienced the highest frequency of complications were those waiting between 301 and 500 days. Conclusions With every cohort beyond 200 days experiencing complications, a clear relationship is seen between a longer waiting time and risk of complications. The government must act to prevent patients waiting so long for laparoscopic cholecystectomy, to increase the chances of a low risk operation.