TPT 3.11 Evaluating Emergency Appendicectomy Practice in a District General Hospital: A Retrospective Audit
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2026
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Abstract
Abstract Aims Emergency appendicectomy is a common urgent surgical procedure, with national guidance emphasising timely surgery, appropriate use of diagnostic imaging, and rational postoperative antibiotic prescribing. This audit evaluated emergency appendicectomy practice in a district general hospital reviewing these principles. Methods A retrospective audit was conducted of emergency appendicectomies performed between January and June 2025. Data was collected from theatre logbooks and electronic records, including time from decision to operate to surgery, documented reasons for delay, use and findings of preoperative imaging, histopathology results, postoperative antibiotic prescribing, and 30-day readmission rates. Results 186 emergency appendicectomies were included. Surgery was performed within 24 hours of decision to operate in 73.4% of cases. Of delayed procedures, 45.0% had documented justification, with lack of emergency theatre capacity accounting for 41.0% of recorded delays. Histopathology confirmed acute appendiceal pathology in 79.0% of cases. Preoperative imaging was performed in 61.3% of patients. Of CT scans reported as acute appendicitis, 27.3% showed no histological evidence of appendicitis, while 25.0% of ultrasound-diagnosed cases were histologically negative, contributing to a notable negative appendicectomy rate. Postoperative antibiotics were prescribed in 67.2% of cases, with substantial variation in choice and duration. No clear association was identified between antibiotic prescribing and postoperative recovery or 30-day readmission. Conclusion This audit identified delays to surgery primarily related to theatre capacity, inconsistencies in diagnostic pathways, and variation in postoperative antimicrobial prescribing. Standardised imaging protocols, improved theatre prioritisation and evidence-based antibiotic guidelines may reduce negative appendicectomy rates and improve patient care. Re-audit following implementation is planned.
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| Authors | Clodagh Holmes, Renee Yantin, Sujeewa Chaminda Sellahewa, Shasika E K Mahappuge |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.194
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| Keywords | Keywords not found |
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