TTP7.10 Compliance with NCEPOD Guidelines in the Management of Acute Pancreatitis - A Closed Loop Audit

Abstract Aim The management of acute pancreatitis requires prompt identification and treatment of the underlying cause. Early antibiotics are not recommended initially, as organ dysfunction is not primarily due to bacterial infection. For gallstone pancreatitis, cholecystectomy should ideally occur during the initial hospitalization once symptoms improve. This audit aimed to assess management practices against NCEPOD recommendations to influence future practice. Methods We conducted a retrospective analysis of acute pancreatitis cases diagnosed biochemically or through imaging from June to October 2023, presenting results at a local meeting. We recommended increasing “hot chole” slots and establishing dedicated waiting lists for gallstone pancreatitis. We re-evaluated these changes from June to October 2024. Results 64 patients were audited in the first cycle, compared to 66 in the second. Gallstone pancreatitis was diagnosed in 33 (51%) and 32 (48%) patients, respectively. MRCP and/ or EUS usage for unclear aetiology rose from 37% to 48%, while inappropriate antibiotic prophylaxis decreased from 42% to 28%. Previous admissions for gallstones decreased from 12 (36%) to 5 (16%). Early cholecystectomy rates improved from 18% to 31%. Conclusions There was a reduction in antibiotic prophylaxis and an increase in MRCP and/ or EUS usage for unclear aetiology. Additional “hot chole” slots and dedicated waiting lists improved early cholecystectomy rates and reduced repeat admissions with gallstone flare-ups.