AB070. SOH24AB_097. A long way from Tokyo?—Management of patients with acute cholecystitis in Ireland: a national registry-based study
Plenary Session

AB070. SOH24AB_097. A long way from Tokyo?—Management of patients with acute cholecystitis in Ireland: a national registry-based study

Robert O’Connell1, Niall Hardy1, Leona Ward1, Anthony Stafford2, Donal Maguire2, Fiona Hand2, Emir Hoti2, Criostóir Briain Ó Súilleabháin3, Adrian O’Sullivan3, Tamara Gall1, Gerry McEntee1, John Conneely1

1Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland; 2Department of Surgery, Saint Vincent’s University Hospital, Dublin, Ireland; 3Department of Surgery, Mercy University Hospital, Cork, Ireland

Background: Acute cholecystitis is a common general surgical emergency, accounting for up to 10% of all patients attending with acute abdominal pain. International guidelines suggest that emergency cholecystectomy is the treatment of choice for uncomplicated acute cholecystitis where feasible.

Methods: All patients with acute cholecystitis presenting to public hospitals in Ireland between January 2017 and July 2023 were identified using the National Quality Assurance and Improvement System (NQAIS). Data were collected on patient demographics, co-morbidities, length of stay (LOS), operative intervention, endoscopic intervention, critical care admissions, in-patient mortality, and readmissions.

Results: A total of 20,886 admission episodes were identified involving 17,958 patients. Among them, 3,585 (20%) patients underwent emergency cholecystectomy in total; 3,436 (96%) of these were performed laparoscopically, with 140 (4%) requiring conversion to an open procedure, and common bile duct injuries occurring in 4 (0.1%) of patients. In comparison to patients treated conservatively, patients who underwent cholecystectomy were younger (median 50 vs. 60 years, P<0.001) and more likely to be female (64% vs. 55% P<0.001). Following propensity score matched analysis, those who had an emergency cholecystectomy had reduced LOS [median 5 days, interquartile range (IQR): 3–8 days vs. 6 days, IQR: 3–10 days, P<0.001] and fewer readmissions to hospital {282 (8%) vs. 492 (14%), age >65 years [odds ratio (OR): 1.526], Charlson comorbidity index (CCI) >3 (OR: 2.281) and non-operative management (OR: 1.136)} were significant risk factors for adverse outcome.

Conclusions: Uptake of emergency cholecystectomy in Ireland remains low, and is carried out on a younger, fitter cohort of patients. In those patients, however, it is associated with improved outcomes for cholecystitis compared to conservative management.

Keywords: Cholecystectomy; cholecystitis; emergency; general; surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab070
Cite this abstract as: O’Connell R, Hardy N, Ward L, Stafford A, Maguire D, Hand F, Hoti E, Ó Súilleabháin CB, O’Sullivan A, Gall T, McEntee G, Conneely J. AB070. SOH24AB_097. A long way from Tokyo?—Management of patients with acute cholecystitis in Ireland: a national registry-based study. Mesentery Peritoneum 2024;8:AB070.

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