O-EGS09 Effect of introducing an ambulatory care service on management of patients requiring acute cholecystectomy

Abstract Background Biliary pathology is a large tranche of the emergency surgical take, taking up many bed days, with patients not receiving definitive management on their primary admission. An Emergency Surgical Ambulatory Care (ESAC) service was established at our hospital in 2019, aiming to provide streamlined platform for diagnosis and patients. Most notably this included symptomatic gallstones which could be managed semi-urgent basis without We aim analyse efficiency novel hopes identifying room improvement so that we may enhance patient outcomes. Methods Two time periods were retrospectively assessed; September-December 2018 (pre- ESAC) 2019 (six months after ESAC started). Patients Cholelithiasis (ICD-K80) Cholecystitis (ICD-K81) identified, those either an incidental symptoms, gallstone pancreatitis, severe inflammation (empyema, gangrene, perforation), requiring ERCP or if they unfit surgery excluded. Data collected number admissions, length stay rate cholecystectomy. divided into SAU, SAU compare difference are presented as median (range). Results Some 57 acutely compared 82 2019. The wait operation 43.5 days significantly reduced 7 Conclusions introduction has allowed reduction total waiting surgery. Use shown more efficient terms occupation indirectly, utilization resources. high success also ensures fewer re-presenting same acute take hence contributes reducing strain on-call team. Further work being done reduce presenting through pathway, preferentially attending ESAC.