Middle-grade led Expedited Gall bladder lists: Is it safe and feasible?

Area of Science:

• General Surgery
• Surgical Services Management

Background:

• Gallstone-related admissions represent a significant burden on acute general surgery services.
• Dedicated expedited gall bladder list services are clinically effective and cost-effective but often limited by resources, such as surgical staff.
• Hospitals face logistical challenges in providing dedicated gall bladder surgical lists.

Purpose of the Study:

• To evaluate the safety and efficacy of a newly implemented middle-grade-led expedited gall bladder list service.
• To assess the feasibility of this model as an alternative to traditional consultant-led services.

Main Methods:

• Retrospective analysis of prospectively collected data from February 2022 to September 2023.
• Patients were triaged via questionnaire and underwent surgery within 2-8 weeks of admission.
• Outcomes included complications, readmissions, and the need for consultant involvement.

Main Results:

• 101 patients were included, with a mean age of 50.59 years; most were female with ASA grade 2.
• Consultant assistance was needed in 14 cases (9 with active participation).
• Complication rates were comparable to national averages, including bile leaks and a small bowel injury; 6 readmissions occurred.

Conclusions:

• The middle-grade-led expedited gall bladder service proved to be a safe and effective alternative.
• This model offers a pragmatic solution to surgical demands within staff and facility constraints.
• The service successfully addressed limitations preventing consultant-led lists.