What criteria should I use to refer a patient with gallstone-related c

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Referral criteria for patients with gallstone-related complications to secondary care include:

Emergency admission for any person aged 18 or over who is systemically unwell with suspected complications such as acute cholecystitis, cholangitis, or pancreatitis .
Urgent referral to gastroenterology or surgical services with biliary expertise for people with known gallstones and jaundice, or clinical suspicion of biliary obstruction indicated by significantly abnormal liver function tests .
Referral of all patients diagnosed with symptomatic gallstone disease to a surgeon for consideration of laparoscopic cholecystectomy, with urgency based on clinical judgement .
Hospital admission for suspected acute cholecystitis to confirm diagnosis, monitor clinical status, and initiate treatment including intravenous fluids, antibiotics, analgesia, and surgical assessment for cholecystectomy .
Referral for bile duct clearance and laparoscopic cholecystectomy in patients with symptomatic or asymptomatic common bile duct stones due to risk of serious complications such as cholangitis or pancreatitis ,.
Consideration of percutaneous cholecystostomy for gallbladder empyema when surgery is contraindicated and conservative management fails .
Emergency referral if pain from gallstone disease cannot be managed in primary care .

What criteria should I use to refer a patient with gallstone-related complications to secondary care?