The management of acute cholecystitis and its hospital cost.

This retrospective study compares the hospital costs of early and delayed cholecystectomy in the treatment of patients presenting with acute gallbladder disease. Of patients on the waiting list for delayed cholecystectomy, 27 per cent were readmitted as emergencies. The operating time was the same for early and delayed cholecystectomy. The overall average length of stay in the delayed group (16.1 days) was significantly greater (P < 0.001) than in the early group (12.4 days). The main difference in length of stay was due to the initial medical admission in the delayed group. The hospital costs, calculated on the basis of length of stay and hospital attendances, were pounds 156 cheaper (at 1977/78 prices) for early than for delayed cholecystectomy. Although the numbers were too small for valid statistical analysis, surgical outcome as measured by numbers of deaths, complications and readmissions was similar in the two groups. If more early cholecystectomies were performed, costs might be saved and surgical waiting lists reduced.