TPW 7.13 Audit into the Management of Gallstone Pancreatitis at A Tertiary Care NHS Trust

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ID: 323958
2026
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Abstract
Abstract Background NICE guidelines recommend early cholecystectomy for patients with gallstone pancreatitis (unless severe), either during the index admission or within two weeks of discharge, to prevent recurrent biliary events. This audit assessed compliance with NICE guidance at a teaching hospital. Methods All patients admitted between 1 June 2025 and 15 September 2025 with biochemical and/or radiological evidence of acute pancreatitis and radiological confirmation of gallstones were included. Data collected included patient demographics, severity of pancreatitis, timing of cholecystectomy, and documented reasons for delay when surgery was not performed during the index admission. Results Thirty-one patients were identified; 18 (58%) were female. Twenty-seven patients (87%) had mild pancreatitis, three (9.6%) had moderate pancreatitis, and one (3%) had severe pancreatitis. Among patients with mild or moderate pancreatitis (n=30), only two (6.6%) underwent cholecystectomy during the index admission. Fourteen patients (45%) underwent elective cholecystectomy within five months of discharge; however, only two (14%) received surgery within the NICE-recommended two-week period. Common reasons for delay included uncertainty regarding surgical fitness (n=4), awaiting MRCP results (n=6), and awaiting ERCP (n=3). Three patients (10.7%) were readmitted with recurrent biliary pathology following their index admission. Conclusion Compliance with NICE-recommended early cholecystectomy following gallstone pancreatitis was poor, exposing patients to avoidable risk of recurrent biliary events and readmission. We aim to improve compliance by introducing a dedicated hot cholecystectomy pathway with protected theatre capacity and re-audit to assess the impact on adherence to NICE guidance and readmission rates.
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Authors Winnie Lam, Yousef Alsardia, Nida Khan, Mazin Mohamed, Abdul Malik Magsi, Antonios Athansiou
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.382
URL
https://doi.org/10.1093/bjs/znag087.382
Keywords Keywords not found

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