Surgical management of acute cholecystitis in Norway - a registry study.

BACKGROUND AND AIM: Acute cholecystitis is a common cause of emergency admissions to surgical departments, and international guidelines recommend cholecystectomy during the initial hospital stay for most patients. A recently published survey indicates considerable variation in practice in Norway. The aim of this study was to further investigate national variations in the surgical management of acute cholecystitis in Norway.

MATERIAL AND METHOD: This registry study used data from the Norwegian Patient Registry. All patients aged ≥ 18 years who were admitted as emergencies between 2010 and 2025 with a first-time diagnosis of acute cholecystitis, based on relevant ICD-10 codes, were included. Variation between hospitals was also analysed for the period 2020-25.

RESULTS

A total of 37,944 patients were admitted with acute cholecystitis for the first time during the study period, increasing from 1,710 in 2010 to 3,150 in 2025. Of these, 8,842 (23.3%) underwent surgery during their initial hospital stay, increasing from 221/1,710 (12.9%) in 2010 to 1,091/3,150 (34.6%) in 2025. Between 2020 and 2025, the proportion undergoing surgery during their initial hospital stay ranged from 2/430 (0.5%) to 240/325 (73.8%) across hospitals.

INTERPRETATION: The proportion of patients undergoing surgery for acute cholecystitis in Norway has increased, but there is considerable variation between hospitals. These findings suggest that the management of acute cholecystitis in Norway should be more closely coordinated.