330 Use of Percutaneous Cholecystostomy - Mission Creep or a Genuine Bridge to Surgery?

Abstract Aim Appropriately used, percutaneous cholecystostomy (PC) can be lifesaving. We have noted an increase their use. This may due to increasing population frailty combined with delayed presentations or treatment from the COVID pandemic. sought audit use of PC in our Trust. Method Retrospective analysis prospectively collected data 2020-2022 at a large DGH comparison insertion standards (failed antibiotic response & not fit for surgery, septic/too unstable as definitive treatment). Results performed 67 times 64 patients (F = 36.5%. mean age 72 (45-92yrs)). 31 (48.4%) were treatment. 36 (53.7%) definitive, 19 subsequently underwent surgery (5 readmissions, 12 elective 2 same admission). 25 did meet criteria and potentially could been considered emergency laparoscopic cholecystectomy. 35.8% (n 24) had DNACPR place time drain insertion. 25.4% 17) died analysis. In timeframe n 168 cholecystectomies completed. Conclusions is effective strategy but suggest that some suitable operative intervention, indicative “mission creep”. However, reasons this are unclear, include availability hot list slots, before weekend where subspecialty UGI surgeons hand genuine belief beneficial bridge surgery. The wider role requires further evaluation, especially if cover available.