458 Post-COVID-19 Regularisation of Emergency Laparoscopic Cholecystectomies: A Single-Centred Multi-Cycle Audit

Aim The COVID-19 pandemic has increased the number of emergency laparoscopic cholecystectomies due to elective surgery cancellations. However, the impact of COVID-19 on the timing of surgery remains unclear. The Association of Upper Gastrointestinal Surgery (AUGIS) advised to perform an emergency laparoscopic cholecystectomy within 72 hours of diagnosing acute cholecystitis. This audit aims to evaluate the impact of the post-COVID-19 period on the timing of emergency laparoscopic cholecystectomies. Method A retrospective analysis of patients who underwent an emergency laparoscopic cholecystectomy, in the post-pandemic period, between January and December 2022 was conducted. Primary outcomes include admission to imaging time, admission to theatre time, length of hospital stay, intra- and post-operative complications. Outcomes were audited against AUGIS guidelines and compared with previous audit cycles during the pre-pandemic (2019) and pandemic (2021) periods. Results In 2022, 411 patients underwent an emergency laparoscopic cholecystectomy. Median admission to imaging time was 11 hours (IQR 4.6-21.9). Median admission to theatre time was 70.7 hours (IQR 48.4-107.7), compared to 106.5 hours in 2019 and 76.7 hours in 2021. Median length of hospital stay was 5.6 days (IQR 4.0-8.1), compared to 7.5 days in 2019 and 5.3 days in 2021. There were 38 (9.2%) subtotal cholecystectomies, 112 (27.3%) on-table cholangiograms, and 57 (13.9%) CBD explorations performed. 61(14.8%) patients had post-op complications including 9 (2.2%) bile leaks, 5 (1.2%) retained stones, and 7(1.7%) collections. Conclusions Timings to emergency laparoscopic cholecystectomies continue to improve in the post-COVID-19 period and is consistent with AUGIS recommendations.