Acute cholecystitis accounts for approximately 10 % of all patients attending the emergency department with acute abdominal pain [1]. Whilst international consensus guidelines recommend emergency operative intervention where possible [2,3], data confirms that a mere 20 % of Irish patients presenting with acute cholecystitis proceed to operative intervention during their index admission [4]. This is in comparison to 32.2 %, 48.9 %, 60.4 %, and 59 % in Sweden, England, Scotland, and Ontario, Canada respectively [[5], [6], [7], [8]].

This is despite the emergence of evidence suggesting that emergency cholecystectomy has several significant advantages over a delayed cholecystectomy approach [9]. Early intervention reduces the rate of wound infection and length of stay (LOS) and enhances patient quality of life whilst remaining equivocal to delayed intervention with respect to mortality and major complications, such as common bile duct (CBD) injury [2,9].

Guidelines suggest that whilst performing a cholecystectomy within seven days of hospital admission is safe, that optimal reduction in morbidity is observed when the procedure is carried out within 72 h of admission [2,3]. However, tangible barriers exist to compliance with this timeframe. The lack of availability of experienced or hepatobiliary surgeons is the most commonly quoted limitation, in addition to practical factors such as access to emergency theatres, requisite bile duct imaging and operative cholangiography [10]. The extent of the impact of these factors on “time to theatre” in Ireland is unknown, as well as the resultant influence on outcomes.

The aim of this study is to evaluate the “time to theatre” for emergency cholecystectomy in the setting of acute cholecystitis in Ireland and to examine the influence of operative timing on relevant peri-operative outcomes.