A survey of current surgical treatment of acute gallstone disease in the west of Scotland.
BACKGROUND
National guidelines exist for the treatment of acute gallstone pancreatitis, but not for the management of acute cholecystitis (AC).


OBJECTIVE
To establish the preferred management of uncomplicated AC and adherence to guidelines for the management of mild gallstone pancreatitis in the west of Scotland.


METHODS
A postal survey of all 100 consultant general surgeons in the west of Scotland.


RESULTS
67 of 71 responses received were suitable for analysis. For uncomplicated AC, 24 (36%) perform urgent laparoscopic cholecystectomy (LC), 16 (24%) perform same admission LC after clinical improvement. 23 (34%) perform interval LC after discharge. Within this group, 9 surgeons (13%) manage AC conservatively due to insufficient operating time or equipment when on call. In mild gallstone pancreatitis, 33 (49%) perform same admission LC, 13 (19%) perform sphincterotomy, 3 (4.5%) perform one of these depending on the patient and 6 (9.5%) refer to a colleague with an interest in upper gastrointestinal surgery.


CONCLUSIONS
The majority of surgeons (over 60%) manage AC with same admission LC. Of those who do not, more than a third report lack of resources as being the reason. The majority of surgeons in the West of Scotland manage mild gallstone pancreatitis in accordance with current guidelines.
Campbell
E J
EJ
Division of Cancer Sciences and Molecular Pathology, Section of Surgery, Glasgow Royal Infirmary, Glasgow.
Montgomery
D A
DA
MacKay
C J
CJ
D000208:Acute Disease; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D041881:Cholecystitis, Acute / Q000601:surgery*; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010195:Pancreatitis / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012606:Scotland; D013043:Specialties, Surgical; D011795:Surveys and Questionnaires