374 Better Long-Term Outcomes After Cholecystitis in the Very Elderly After Cholecystectomy or ERCP

Abstract Aim With an aging population, we are treating increasing numbers of elderly patients for acute gallstone disease. The gold standard treatment for gallstones remains a cholecystectomy however this may not be suitable for patients who are frail or co-morbid. We present the 10-year follow up data of our 2019 audit, assessing the management of acute gallstone pathology in an elderly cohort. Method 75 patients (aged >80 years) who were admitted between 2015-2018, with acute gallstone disease, at a single district general hospital, were included in the original audit. 1 patient was lost to follow-up therefore excluded from the re-audit. Patient data was collected from CERNER and analysed using Microsoft Excel. Results 74 patients were included in the re-audit. 46% of patients were female and 54% male. 34/74 (46%) patients were admitted with cholecystitis and 40/74 (54%) patients with ascending cholangitis, obstructive jaundice or pancreatitis. 34/74 patients were treated with antibiotics only. 40/74 patients were treated with intervention in the form of ERCP (24), cholecystostomy (5) and cholecystectomy (11). Of those patients discharged, the average number of days from death to discharge was greater in the intervention group (1157d) than antibiotics (837d) but was not significant (p=0.09). There was a higher number of deaths due to gallstone disease in the antibiotic group (10/34) compared to the intervention group (5/40). In total 20% of patients died from gallstone disease. Conclusions In total, 1 in 5 patients died from gallstone disease. Patients that underwent intervention had longer survival times and lower mortality attributed to gallstone disease.