EP.TH.15Review of cholecystectomies laparoscopic & open plus conversion rate in a five year period

Aim Look & audit our practice of cholecystectomy & try to identify areas that require improvement Method Look at all cholecystectomies, laparoscopic & open in 5 years from January 2014 till December 2018, we looked at demographics, number of operations per year, conversion & re-admission rate, information collected from electronic note record Results male to female ratio similar to national figures, number of laparoscopic operations (2422 in that period, 61 cases converted, conversion rate 2.5%) going up steadily over the 5 years while open & conversion rate are dropping significantly, early re-admission rate higher than national figure, reasons for conversion determined & analysed Reasons for doing it open from the start also determined, commonest cause for conversion in our trust is: previous surgery/adhesions, obscure anatomy & severe inflammation of gall bladder . Commonest cause of re-admission is pain followed by wound complications collections retained stone & bile leak. Number of open cholecystectomies was 22 in 2104 dropping to only 2 in 2018. 3 deaths occurred in the group giving rise to a mortality of 0.12% Conclusion Majority of cases attempted laparoscopically & most patients discharged home within 48 hours, our conversion rate is low = 2.5% with consultants with higher number of operation having less conversions, ours re-admission rate is high mainly for pain, our mortality is low. We recommend looking closer at re-admissions to see how that number could be reduced.