921 Management of Acute Cholecystitis - the MACHO Study

Abstract Background Acute cholecystitis is a common surgical condition. Gold standard treatment index cholecystectomy, although there are reasons this might not be offered. The aim of study was to explore treatments and outcomes in patients with acute cholecystitis. Method A multicentre retrospective carried out identify historic three-month cohort. Patients were identified through clinical coding. Demographics, outcomes, comorbidities, Tokyo grade, intervention descriptors collected. Logistic regression performed characteristics receiving drain, propensity match for outcomes. Results Seven centres reported on 1130 patients. Median age 62 years, 145 (12.8%) had grade III Grade present 19 (25.6%) those who underwent cholecystostomy, 34 (9.3%) 92 (13.3%) conservatively managed. Overall complication rates higher managed cholecystostomy (36.5%) or (22.6%) vs cholecystectomy (7.5%) (p < 0.001). found CCI associated increased any complication. Increased II/III major complications. Conclusions 'Hot' laparoscopic seems offered mild cases fit disease moderate comorbidities may have timely manner, leaving them at risk repeated severe episodes.