Patterns of Practice in Cholecystectomy in the United Kingdom. A Secondary Interim Analysis of Feasibility of Predicting Incidental Gallbladder Cancer

Aim: Cholecystectomy is one of the most common general surgical operations performed in the United Kingdom. However, practice can vary considerably between units. The aim of this study was to describe real-world patterns of cholecystectomy practice in the UK, using a secondary analysis of data from Feasibility of Predicting Incidental Gallbladder Cancer (fP-iGBC).

Method: fP-iGBC prospectively identified consecutive adult patients undergoing cholecystectomy for benign disease in eight units in South West England between October 2024 and March 2025. For this secondary interim analysis, we examined data on patient demographics, waiting times, pre-and intra-operative imaging, interventions and adjuncts, and peri-operative outcomes. Data are reported using descriptive statistics.

Results: A total of 505 (358 female, 70.9%) patients underwent cholecystectomy in the study period, with a median age of 53 (19-90) and median BMI of 30.9 (18.5-58.4). Patients waited a median of 62 days (0-1129) for cholecystectomy. The most common indications for surgery were biliary colic (263, 51.8%) and cholecystitis (209, 41.4%). Pre-operative ultrasound was performed in 454 (89.4%) patients. ERCP was required for 42 (8.3%) patients and 5 (1.0%) underwent cholecystostomy. Minimally invasive approaches were used in 487 (96.4%) patients of which 11 (2.3%) were converted to open. 3 (0.6%) cholecystectomies were abandoned after trial dissection. Subtotal cholecystectomy was performed in 20 (3.9%) cases. Intra-operative ultrasound was used in 32.2% of cases.

Conclusions: This secondary analysis describes current patterns of cholecystectomy practice in the UK. These findings provide a contemporary reference point for UK practice and may inform future guideline development and support service planning.