ArticleSurgical endoscopy2019
Optimum timing of emergency cholecystectomy for acute cholecystitis in England: population-based cohort study.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Routine use of ICG to enhance operative safety in emergency laparoscopic cholecystectomy: a randomized controlled trial.Surgical endoscopy · 2022Trial
- Acute cholecystitis in the robotic era: comparative safety and feasibility of robotic and laparoscopic cholecystectomy in an acute care surgery service.Journal of robotic surgery · 2026Article
- Comparative Early Postoperative Outcomes in Acute Calculous vs. Acute Acalculous Cholecystitis: A Retrospective Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Review
- Clinical and financial impact of a 'difficult' laparoscopic cholecystectomy.ANZ journal of surgery · 2025Article
- Outcomes after index cholecystectomy: a UK longitudinal multi-centre cohort Study.Langenbeck's archives of surgery · 2025Article
- Clinical update on acute cholecystitis and biliary pancreatitis: between certainties and grey areas.EClinicalMedicine · 2024Review
- Temporal Analysis of the Incidence, Mortality and Disability-Adjusted Life Years of Benign Gallbladder and Biliary Diseases in High-Income Nations, 1990-2019.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Improving early cholecystectomy rate in acute cholecystitis with an evidence-based local multidisciplinary protocol and a surgical audit: single-center experience through an Acute Care Surgery Division.Langenbeck's archives of surgery · 2024Article
- Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study.World journal of emergency surgery : WJES · 2024Observational
- Intraoperative transcystic laparoscopic common bile duct stone clearance with SpyGlass™ discover during emergency and elective cholecystectomy: a single-center case series.World journal of emergency surgery : WJES · 2024Article
- Near-infrared indocyanine green fluorescent cholangiography in urgent and emergency laparoscopic cholecystectomy: a preliminary study after propensity score-matched study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Article
- Prospective validation of the Israeli Score for the prediction of common bile duct stones in patients with acute calculous cholecystitis.Surgical endoscopy · 2023Observational
- Timing of Early Cholecystectomy for Acute Calculous Cholecystitis: A Multicentric Prospective Observational Study.Healthcare (Basel, Switzerland) · 2023Article
- Symptom Duration and Surgeon Volume: Impact on Early Laparoscopic Cholecystectomy for Acute Cholecystitis.Cureus · 2023Article
- Sequential histologic evolution of gallbladder inflammation in acute cholecystitis over the first 10 days after onset of symptoms.Journal of hepato-biliary-pancreatic sciences · 2023Article
- The Optimal Timing of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Single-Center Study.Cureus · 2023Article
- Specialist-led urgent cholecystectomy for acute gallstone disease.Surgical endoscopy · 2023Article
- Editorial: Surgical outcomes in acute care surgery: should we introduce the concept of time-critical condition?Frontiers in surgery · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCholecystectomy on index admission for acute cholecystitis is associated with improved patient outcomes. The timing of intervention is mainly driven by service provision. This population-based cohort study aimed to evaluate timing of emergency cholecystectomy in England.
methodsData from all consecutive patients undergoing surgery for acute cholecystitis on index admission in England from 1997 to 2012 were captured from the Hospital Episodes Statistics database. Data were analysed based on whether patients underwent surgery 0-3 days, 4-7 days or ≥ 8 days from admission. Outcome measures were rate of post-operative biliary complications, conversion to open and length of stay.
resultsForty-three thousand eight hundred and seventy patients underwent emergency cholecystectomy. 64.6% of patients underwent surgery between days 0 and 3 of admission, 24.3% between days 4-7 and 11.0% had surgery after day 8. Patients undergoing early surgery had significantly reduced rates of intra-operative laparoscopic conversion to open (0-3 days: 3.6%; 4-7 days: 4.0%; ≥ 8 days 4.7%, p = 0.001), post-operative ERCP (0-3 days: 1.1%; 4-7 days: 1.5%; ≥ 8 days 1.9%, p < 0.001) and bile duct injury (0-3 days: 0.6%; 4-7 days: 1.0%; ≥ 8 days 1.8%, p < 0.001). Early cholecystectomy was also associated with a shorter post-operative length of stay (LOS) [0-3 days group: median post-operative LOS 3 days (IQR: 1-6); 4-7 days group: 3 days (IQR 2-6); ≥ 8 days group: 4 days (IQR 2-9) (p < 0.001)]. High-volume centres undertook a significantly greater proportion of cholecystectomies within 3 days of presentation (high-volume: 67.3%; medium-volume: 64.8%; low-volume: 61.2%). In multivariate analysis greater time to surgery was independently associated with increased risk of post-operative ERCP and bile duct injury.
conclusionsEarly cholecystectomy within 3 days of admission reduces intra-operative conversion, post-operative biliary complications and length of stay. Centres undertaking the greatest numbers of emergency cholecystectomies perform a larger proportion within 3 days of admission.
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