SP4.14 Day-case definitive management of patients presenting with acute biliary pancreatitis – a case series from a single UK centre

Acute biliary pancreatitis (ABP) is a common condition, necessitating timely intervention to prevent complications. While early Laparoscopic cholecystectomy (LC) is standard definitive treatment, role of day-case surgery in acute presentation remains under-explored. Delays in surgery or repeated hospital admissions can increase healthcare costs particularly within NHS. This case series aims to evaluate feasibility, safety, and outcomes of performing same-day magnetic resonance cholangiopancreatography (MRCP) and LC in patients with ABP. This prospective case series that followed 12 patients diagnosed with ABP between September 2023 and September 2024. Cohort included ASA 1 and 2 patients; 7 females and 5 males, age range 39 to 63 years, all presenting with diagnostically elevated amylase. Alanine transaminase (ALT) was > 150 in all patients on admission. None of the patients had a significant alcohol history. On presentation, all patients underwent an MRCP (+/- preceding USS if they were not known to have gallstones) and were classified as having mild pancreatitis. Based on MRCP findings, all patients underwent LC on same day. All 12 patients successfully underwent same-day MRCP and LC without intraoperative or postoperative complications. All patients were discharged on same day, prior to 8 p.m. No readmissions or complications were observed during follow-up period. This case series demonstrates that same-day MRCP and LC is safe and highly effective approach for managing ABP. This approach not only ensures high-quality patient outcomes but also highlights potential for reducing healthcare costs within NHS. Further studies with larger cohorts are needed to confirm these findings and establish broader clinical guidelines.