Tackling a Post-COVID-19 Cholecystectomy Waiting List: Are We Meeting the Challenge?

Area of Science:

• Surgical Outcomes
• Healthcare Management
• Public Health

Background:

• The COVID-19 pandemic caused substantial delays in elective surgical procedures, creating significant patient waiting lists.
• Cholecystectomy (gallbladder removal) waiting times became a critical issue, impacting patient care and outcomes.
• A large UK hospital trust implemented novel strategies to address the elective cholecystectomy backlog.

Purpose of the Study:

• To evaluate the impact of an innovative, multi-faceted approach on cholecystectomy waiting times.
• To assess trends in overall cholecystectomy activity during the post-COVID-19 recovery phase.
• To determine the effectiveness of strategies in reducing elective surgical backlogs.

Main Methods:

• A prospective observational study was conducted over 12 months (February 2021-February 2022) at a UK hospital trust.
• Multiple strategies were employed: utilizing the private sector, multiple surgical sites, mobile operating theatres, and extended working hours (seven-day operations).
• Statistical analyses, including correlation of determination (R² ) and Kruskal-Wallis tests, were used to analyze waiting time trends.

Main Results:

• A total of 657 cholecystectomies were performed, with a median patient age of 49 years and predominantly healthy patients (ASA 1-2).
• Median waiting times for cholecystectomy decreased dramatically from 428 days to 49 days (R² = 0.654, p < 0.001).
• Waiting times for gallstone pancreatitis cases reduced from 218 days to 28 days (R² = 0.613, p < 0.001).

Conclusions:

• The implemented methodology successfully and safely reduced the cholecystectomy waiting list.
• This innovative, multi-pronged approach demonstrates significant potential for reducing elective surgical waiting times.
• The strategies employed can be adapted by other healthcare units for similar surgical procedures to improve patient access.