WE2.11 Optimal Utilisation of Cross-Sectional Imaging in Patients with Painful Jaundice Undergoing Bile Duct Exploration or Conservative Management for Suspected Bile Duct Stones on a Specialist Unit

Abstract Aim Laparoscopic management of bile duct stones relies on intraoperative cholangiography, optimising utilisation preopertative imaging. This study aims to determine whether such a policy is justifiable in jaundiced patients over 50 years age with no risk factors for malignancy. Methods Prospectively collected data presenting gall and painful jaundice undergoing biliary surgery or treated conservatively was analysed. The presentation, preoperative imaging, cholangiography/ choledochoscopy findings postoperative outcomes were recorded. Patients malignancy excluded. Results 1220 referred 24 years. 684 underwent having had CT 15.3%, MRCP 10% ERCP 2.5%. 536 unfit managed (CT 15.7%, 27.8% 29.5%). Most these investigations under the care other departments prior referral. 21/684 (3%) associated acute cholecystitis diagnosed IOC choledochoscopy. 7 cross sectional one showing evidence remaining 14 imaging; radiologically undetectable disease, 6 advanced disease only suitable “curative resection”. 21/536 (3.9%) cancers who conservatively. Conclusion Based little diagnostic yield curable malignancies, imaging obstructive units adopting single session stones.