Background: NHS hospitals currently have limited capacity in emergency theatres for emergency Laparoscopic Cholecystectomy (LC). A pathway was introduced in this Trust allowing for emergency LC to be performed on an elective operating list. This study aims to assess its impact on patient care.Methods: Acute admissions with biliary complaints from April to September 2014 were identified prospectively (Group 1). Mode of referral for patients undergoing elective LC during the same period along with other data was collected retrospectively (Group 2). The two groups were compared for readmission rates, length of hospital stay (LOS) and conversions.Results: Of the 207 acute admissions, 115 (56%) were eligible for emergency surgery. Thirty-three patients (28.7%) had emergency surgery; 20 in emergency theatre and 13 on the pathway. One of 13 was converted to an open procedure. Average LOS for these 13 patients was 8 days. 11 (13.4%) of the remaining 82 patients were readmitted whilst awaiting surgery.Of the 131 patients undergoing elective LC, 38 (29%) were listed for surgery following acute admission prior to introduction of the pathway. Five of the 38 (13.1%) had readmissions whilst awaiting surgery, but none required conversion to open surgery. Average LOS for these 5 patients (including previous readmissions) was 6 days and that for 38 patients was 8 days. Conclusions:The use of elective lists to perform emergency LC is a feasible option. This model of care has facilitated participation in the Chole-QuIC initiative. Expansion and sustained use of this model has enabled more patients to undergo emergency LC. It may prevent readmission in those undergoing delayed LC, although its impact on total LOS, other elective surgeries and conversions remains to be assessed.

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