TPW 4.05 Does Timing of Emergency Laparoscopic Cholecystectomy Impact Surgical Outcomes?
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ID: 324078
2026
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Abstract
Abstract Aims To examine outcomes of emergency laparoscopic cholecystectomies performed at days 7-14 of symptoms, a period associated with higher risk (‘danger window’) versus those operated outside this period. Methods All emergency laparoscopic cholecystectomies performed between 28/08/2023 and 27/12/2024 at a tertiary general surgery centre were included. 914 eligible cases were included. Data were extracted from the electronic patient record. Results 318 of 914 (34.7%) cases were operated within the ‘danger window’. Both groups were demographically similar. There were no inter-group differences in procedure duration, conversion rate, complication incidence, Clavien-Dindo grade distribution, postoperative length of stay, readmission rate or re-intervention rate (p > 0.05). 8 bile leaks were identified and were equally distributed between groups (p >0.05) Excluding cholecystectomy for biliary colic, 256 of 703 (36.4%) cases were operated in the ‘danger window’. Demographics between groups were statistically similar. There were no differences in operating time, conversion rate, complication rate, Clavien-Dindo grade distribution, post operative length of stay, readmission, or reintervention (p > 0.05). However, there was significant difference in rate of bile leak, with all 4 cases occurring in patients operated in the danger window (p < 0.05). No major bile duct injuries occurred in this series. Conclusion The outcomes of emergency cholecystectomy are similar regardless of timing of intervention. In non-biliary colic cases, operating between 7-14 days confers increased risk of bile leak at 1.5% of cases, which approaches quoted rate for uncomplicated gallstone disease. These data challenge the persistent dogma of an unsafe window for emergency laparoscopic cholecystectomy.
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| Authors | James Hughes, Ajay Kapur, Tabitha Gould, Benedict Blacket, Phill Pearce, Giles Bond-Smith |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.332
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| URL | |
| Keywords | Keywords not found |
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