Context

Randomised trial and population-based data support the clinical benefit of early over delayed laparoscopic cholecystectomy for acute cholecystitis.1 Concern of increased risk of major bile duct injury or death with early surgery in the setting of acute inflammation has been refuted and there is 20%–30% risk of recurrent gallstone symptoms if surgery is delayed.2 Early and delayed surgery have also been previously compared with economic models informed by randomised controlled trial and population-based data. While most studies have focused on acute cholecystitis, Sutton and colleagues have considered patients across the spectrum of symptomatic cholelithiasis—biliary colic and cholecystitis—requiring hospitalisation.