Index cholecystectomy in a rural hospital: it can be done
Index cholecystectomy (IC) refers to an operation during the patient's first hospital admission with symptomatic gallstone (GS) disease. This is not a novel idea and has been proposed as early as the 1970s.1 There are proven reductions in cost, hospital bed days and GS‐related complications while awaiting elective surgery.2 Despite this, it is still common practice to discharge patients with a plan for outpatient cholecystectomy. This is particularly true in peripheral hospitals where lack of an available acute team and shared access to theatre facilities can present barriers to IC.4
The aim of this paper is to describe how IC can be achieved in a rural hospital and to examine the effect on waiting time until surgery; GS‐related re‐presentations and complications; operative complications and overall hospital stay.