A Survey of Current Surgical Treatment of Acute Gallstone Disease in the West of Scotland

Abstract

Background

National guidelines exist for the treatment of acute gallstone pancreatitis, but not for the management of acute cholecystitis (AC).

Aims

To establish the preferred management of uncomplicated AC and adherence to guidelines for the management of mild gallstone pancreatitis in the west of Scotland.

Methods

A postal survey of all 100 consultant general surgeons in the west of Scotland.

Results

67 of 71 responses received were suitable for analysis. For uncomplicated AC, 24 (36%) perform urgent laparoscopic cholecystectomy (LC), 16 (24%) perform same admission LC after clinical improvement. 23 (34%) perform interval LC after discharge. Within this group, 9 surgeons (13%) manage AC conservatively due to insufficient operating time or equipment when on call. In mild gallstone pancreatitis, 33 (49%) perform same admission LC, 13 (19%) perform sphincterotomy, 3 (4.5%) perform one of these depending on the patient and 6 (9.5%) refer to a colleague with an interest in upper gastrointestinal surgery.

Conclusions

The majority of surgeons (over 60%) manage AC with same admission LC. Of those who do not, more than a third report lack of resources as being the reason. The majority of surgeons in the West of Scotland manage mild gallstone pancreatitis in accordance with current guidelines.