369 Evaluating Surgical Performance in Cholecystectomy Against National Standards' Key Performance Indicators: A Trust Wide Study

Abstract Aim This study evaluates Key Performance Indicators (KPIs) in cholecystectomy at our Trust, assessing adherence to the British Benign Upper Gastrointestinal Society (BBUGSS) standards. Objectives included monitoring procedural volume, day-case rates, readmissions, index laparoscopic cholecystectomy rates for acute cholecystitis and Gallstone pancreatitis, conversion rates, complications, and mortality in alignment with national benchmarks. Method A retrospective cohort analysis included 599 patients randomised from 983 elective and emergency cholecystectomies performed trust-wide between April 2023 to April 2025. Data were obtained from electronic health records and theatre logs. Assessed KPIs included day-case rates, 30-day readmissions, index laparoscopic cholecystectomy for acute cholecystitis and gallstone pancreatitis, conversion rates, morbidity, bile leak, retained common bile duct (CBD) stones, major bile duct injury, and mortality. Descriptive statistics and chi-square tests were used for analysis. Results No mortality (0%) or major bile duct injuries (0%) were recorded. proportion of index or within two weeks laparoscopic cholecystectomy for gallstone pancreatitis was performed on 16.7% of cases and in 7.5% of those with cholecystitis. The 30-day readmission rate was 6.3%. Retained CBD stones were reported in 0.7%, and bile leaks in 1.5%. Overall morbidity was 11.7%. Subtotal cholecystectomy was performed in 2.3% and conversion to open surgery in 0.2%. Conclusions Outcomes largely align with national KPIs, with no mortality or bile duct injury and low rates of bile leak, retained stones, and conversion. However, the readmission and morbidity rates slightly exceed benchmarks in addition to lower proportion of index operations for cholecystitis and gallstone pancreatitis, indicating potential areas for improvement.