A patient with suspected acute cholecystitis should be admitted to hospital for surgical assessment NICE CKS. Once acute cholecystitis is diagnosed, early laparoscopic cholecystectomy should be offered, ideally carried out within 1 week of diagnosis NICE CKS,NICE CG188. Laparoscopic cholecystectomy is the surgical treatment of choice for people with acute calculous cholecystitis NICE CKS. In specific circumstances, such as gallbladder empyema where surgery is contraindicated at presentation and conservative management is unsuccessful, percutaneous cholecystostomy may be offered NICE CKS,NICE CG188. Additionally, if pain associated with suspected gallstone disease cannot be managed in primary care, an emergency hospital referral is indicated NICE CKS.
When should a patient with suspected cholecystitis be referred for surgical intervention?
Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.
Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX