EP.TH.916Managing Gallstone Pancreatitis: Are We Doing Enough?

Background Acute pancreatitis carries significant morbidity and has an estimated annual incidence of 30-50/100,000 in the U.K. 50% of these cases are related to gallstone disease. NICE/BSG guidelines recommend definitive management of gallstone pancreatitis during the index admission or within 14 days of hospital discharge. We audited our compliance against these national guidelines. Methods Retrospective data was collected for patients admitted with acute gallstone pancreatitis over a 12-month period. Patient demographics, admission details, length of stay, previous/future admissions, timing of cholecystectomy and ERCP were recorded. Results 47 patients were included (mean age: 50.7 years) with a mean length of stay of 6.2 days. Only 6% had a cholecystectomy during the index admission or within 14 days of hospital discharge. 12 (26%) patients had an ERCP performed with a mean time of 45 days. The mean time to surgery after initial discharge was 97 days. Conclusion There is poor compliance with national guidelines in the management of gallstone related pancreatitis in our cohort of patients. Definitive management reduces readmissions, resulting in financial savings and improved patient care. This audit demonstrates the need to develop a robust ‘hot gallbladder’ pathway to improve the management of patients with acute pancreatitis secondary to gallstones.