HPB P46 Does the CholeS pre-operative risk score for laparoscopic cholecystectomy correlate to operative time? A single centre experience

Abstract Background NHS waiting lists for elective surgeries including non-urgent laparoscopic cholecystectomies (LC) have severely escalated during the Covid-19 pandemic, with some patients over 2 years their operations. LCs are highly variable in terms of operative time, difficulty, and risk making theatre utilisation a challenge to effectively clear lists. Nassar et al.[1] developed validated pre-operative prediction score predicting difficult LC using an objective difficulty grading system. We aimed assess if application CholeS could be used predict which may longer times, so aid planning. Methods Consecutive performed between May October 2021 at our institution's day surgery unit were included analysed. Each patient was scored retrospectively from electronic records. Operative time obtained record systems. Data collected on conversion open surgery, post-operative discharge, intra or complications. Outliers operating recorded as <20 minutes considered data entry errors excluded analysis. A ROC analysis used, determined threshold value 3. This divide into low-risk (≤3 points) high-risk (four above) group. Two-sample independent t-test compare mean groups. Levene's test determine variance equal SPSS version 27[2] statistical tests p<0.05 deemed significant. Results 81 53 26 high-risk. There significantly lower group: = 57.6 (95% CI 52.4–63.0) vs 75.8 58.7–92.9), p=0.046. Nine had lasting >90 minutes; 66% these 95% discharged 0, two 1, later. Three cholecystectomy five Two out three who required high scores (7 10). In one patient, cholecystoduodenal fistula found. Cystic duct avulsion occurred other. complications group, corresponding higher Clavien-Dindo (3b, 2) when compared group (1 both patients). Conclusions The scoring system optimise allocation. ≤3 has shorter than four more (mean difference 18.1 mins, 4.4–31.9). Prediction will operations improve allow extra cases booking list. This, turn, help reduce number Additionally, challenging prolonged well those such managed by allocation inpatient specialist upper GI [1] Nassar, A.H.M., Hodson, J., Ng, H.J. al. Predicting cholecystectomy: development validation Surg Endosc 34, 4549–4561 (2020). [2] IBM Corp. Released 2020. Statistics Windows, Version 27.0. Armonk, NY: