P-BN61 Optimal timing of laparoscopic cholecystectomy for admitted acute cholecystitis patients

Abstract Background The Tokyo 2018 guidelines support emergency laparoscopic cholecystectomy (ELC) for acute cholecystitis (AC) over delayed (DLC) mild cholecystitis, substantiated by a lower total length of stay. supporting studies are limited small sample sizes, and clinically relevant findings may have been missed. aims the present paper were firstly, to compare peri- post-operative course following LC AC. Methods All patients who underwent ELC DLC AC hospital admission between January 2015 December 2019 included in study. Pre-operative, operative data 100-day follow-up period collected retrospectively from multiple databases using deterministic records-linkage methodology. Patients splint into groups based on previous admissions outcomes compared DLC. Multivariate logistic regression models then used entire cohort adjust other variables determine impact versus Complications category Clavien-Dindo ≥2 considered. Results In group with no (n = 630), DCL had rates intra-/post-operative complications (8.0%vs.17.9%;p<0.001), re-admission (6.6%vs.12.2%;p=0.04) longer stay (6dvs.5d;p=0.03). 181), (14.1%vs.25.5%;p=0.06) but there was significant difference (13dvs.12d;p=0.81). significantly CRP, ASA age (p < 0.001). multivariate models, positively associated subtotal/conversion open (OR,1.94;p=0.01), drain insertion (OR,2.54;p<0.001), bile leak (OR,2.38;p<0.001), imaging (OR,1.83;p=0.01), (OR,7.26,p<0.001) readmission (OR-1.9;p=0.01). Conclusions DLC, once active inflammation has settled, offers superior outcomes, including complication, stay; however is only advised where risk minimised (i.e surgery six weeks episode) relies management surgical waiting lists.