Early Cholecystectomy after Acute Admission with Cholecystitis: How Much Work?

Background This study was designed to determine the number of cases and amount of operating room time required, for a population of 600,000, to provide definitive treatment in the form of cholecystectomy for all patients admitted as an emergency with cholecystitis. Methods The total number of patients admitted to a single NHS trust in South East Wales with the diagnosis of cholecystitis during a 1-year period was assessed. The number of laparoscopic cholecystectomies performed and the time taken was investigated with the conversion rates. Results There were a total of 787 individual emergency admissions attributed to cholecystitis, and 224 patients (36%) underwent cholecystectomy on the same admission. The median operative time was 77 (range, 23–238) min, and the median operating room time was 108 (range, 37–278) min. To treat all patients definitively would necessitate 12 cholecystectomies per week, requiring 1,296 min or 5.4 sessions of operating room time. Conclusions A population of 600,000 could be expected to generate enough emergency cholecystectomies to require more than one operating session per day. A significant increase in emergency operating room availability would be necessary to allow the provision of definitive treatment for all emergency admissions with cholelithiasis.