SP3.2.1 Management and outcomes of patients with small bowel obstruction in Denmark – a multicentre prospective cohort study

Abstract Aims The optimal management of small bowel obstruction (SBO) remains a matter of debate and treatment varies internationally. In Denmark, the traditional approach to patients with SBO is less conservative than that of the UK, but to what extent patient outcomes differ is unknown. This study aimed to describe the current management and outcomes of patients admitted with SBO in Denmark. Methods This was a prospective cohort study conducted at 6 acute hospitals in Denmark over a 4-month period. Patients aged > 18 years with a clinical or radiological diagnosis of SBO were eligible. Primary outcomes were 30-day mortality and major complication rates. Results 316 patients were included during the study period. The median age was 72 years and 56.0% were female. Diagnosis was made by computed tomography (CT) in 314 patients (99.1%), with the remaining 2 diagnosed clinically. Non-operative management was the initial strategy in 152 patients (48.1%) and successful in 120 (78.9%). Immediate surgery was performed in the remaining 164 (51.9%), with a laparoscopic approach used in 84 patients (51.2%). The 30-day mortality rate was 7.3% with major complications occurring in 61 patients (19.3%). Conclusions The management of SBO in Denmark differs significantly to that of the UK, with more liberal use of CT, a higher proportion of patients undergoing immediate surgery and a higher success rate of non-operative management. Despite these differences, patient outcomes are broadly similar. Adoption of the best components of both strategies may improve patient outcomes in both nations.