Experience with biliary audit

Abstract

Experience with an audit of surgery for gallstones is discussed. Three hundred and forty-six patients were treated in a three and a half year period. There was no mortality. There was a duct exploration rate of 17%, an infection rate of 8.6%, and a re-operation rate for retained bile duct stone of 1.6%. Bile was cultured from 278 gall-bladders and culture was positive in 66 cases (23.7%). The most common organisms grown were coliforms and streptococci. Our antibiotic policy has changed as a result of this study. Audit is becoming increasingly necessary in surgical practice, not only for research purposes, but also to monitor performance. The design can be broad, to identify groups of patients for further study, or narrow, to concentrate on a particular problem. Someone must be responsible for checking the completed forms for accuracy before the data are entered into the computer. It is important that the form be as simple as possible. Forms which are too detailed will be filled in inaccurately or not at all.