TPW 4.13 Emergency Cholecystectomy: Performance, Value and Strategic Opportunity in Acute Surgical Care
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ID: 324080
2026
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Abstract
Abstract Aim To evaluate clinical outcomes, service impact and cost-effectiveness of index-admission emergency cholecystectomy compared with conservative management for acute gallbladder disease, and to identify strategic opportunities for service optimisation within an emergency general surgery model. Methods A retrospective service evaluation was conducted using data collected over a two-year period, comparing patients undergoing index-admission emergency cholecystectomy with those managed conservatively. Outcomes assessed included complications, readmissions, returns to theatre and cumulative hospital utilisation. Cost analysis compared index admission costs and downstream costs related to readmissions and recurrent biliary events. Results Index-admission emergency cholecystectomy was performed in 296 patients with excellent outcomes: one return to theatre, two readmissions and an overall complication rate of 1.7%. In contrast, 438 conservatively managed patients demonstrated significantly poorer outcomes, with a 44% readmission rate (192 cases) driven by recurrent biliary pathology and associated complications. Mean per-patient cost for emergency cholecystectomy was £7,321, representing a definitive single episode of care. Conservative management incurred lower initial admission costs (£3,000–£5,000) but substantially higher cumulative costs due to repeated admissions and prolonged bed occupancy. Conclusions Index-admission emergency cholecystectomy is clinically superior and more cost-effective than conservative management for acute gallbladder disease. Despite delivery within a non-dedicated service model and constrained theatre access, outcomes achieved were among the best regionally and nationally. Targeted investment in protected emergency theatre capacity, consultant support and weekend access offers a clear strategic opportunity to reduce readmissions, improve patient flow, enhance workforce sustainability and secure long-term service excellence.
| Reference Key |
openalex_W7172510645
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| Authors | Anisha Shrestha, Aashutosh Tandon |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.339
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| URL | |
| Keywords | Keywords not found |
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