301 Assessment of Adherence to the WSES Guidelines in the Management of Gallstone Pancreatitis

Abstract Aim To evaluate adherence to the 2019 World Society of Emergency Surgery (WSES) guidelines in the diagnosis and management of gallstone pancreatitis at South Tyneside District Hospital. The primary aim was to assess the adequacy of severity scoring using the Glasgow-Imrie score. A secondary aim was to examine the timing and appropriateness of imaging—particularly MRCP and ERCP—as well as the scheduling of laparoscopic cholecystectomy in accordance with guideline standards. Method A retrospective review was conducted on 192 patients admitted with gallstone pancreatitis between January 2022 and December 2023. Data on patient demographics, Glasgow-Imrie score documentation, imaging modalities (USS, MRCP, ERCP), biochemical trends, and surgical timing were analysed and compared to WSES recommendations. Results Of 192 patients, 62.5% were female, with a mean age of 61.8 years. All parameters of the Glasgow-Imrie score were completed in only 18 patients (9.4%), but no full score was documented in any case. Repeat ultrasound was unnecessarily performed in 41.4% of patients with previously confirmed gallstones. MRCP was conducted in 115 patients (59.9%), with 80 (69.6%) performed within 48 hours. Of these, 80 patients (69.6%) showed a downward bilirubin trend, yet 14 (17.5%) still underwent ERCP. ERCP was performed in 28 patients overall (14.6%), with 9 (32.1%) showing no stones. Early laparoscopic cholecystectomy was inconsistently achieved, often exceeding the two-week post-discharge window. Conclusions Adherence to WSES guidelines was variable. The proposed action plan is to integrate the Glasgow-Imrie scoring template into Meditech V6 to support timely, standardised assessment and improve patient outcomes.