{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T16:22:04Z","timestamp":1770913324099,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":45,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute cholecystitis is a common complication of gallstone disease. Although early laparoscopic cholecystectomy is recommended, some patients do not undergo early surgery and remain at risk of recurrent disease. This study investigated whether early cholecystectomy for recurrent cholecystitis is associated with higher complication rates versus first-time cholecystitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective population-based cohort study was conducted using data from the Swedish Registry of Gallstone Surgery. Patients undergoing early cholecystectomy for acute cholecystitis in Sweden between 1 January 2006, and 31 December 2020, were included. Patients with recurrent cholecystitis were compared to those with a first episode. The primary outcome was the total 30-day complication rate. Secondary outcomes included open surgery, prolonged surgery (\u2265 120\u2005minutes), bile duct injury, and specific complications such as intestinal injury, bleeding, reoperation, abscess, and 30-day mortality. Multivariable logistic regression was used to calculate odds ratios (OR), adjusting for age, sex, American Society of Anesthesiologists (ASA) grade, and time from admission to surgery as confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 34 925 patients, 3384 had recurrent cholecystitis and 31 541 had first-time cholecystitis. The recurrent cholecystitis group had a higher complication rate (20.2 versus 13.8%) and an increased risk of bile duct injury (OR 2.44; 95% confidence interval (c.i.) 1.67 to 3.56), intestinal perforation (OR 2.54; 95% c.i. 1.51 to 4.25), prolonged surgery (OR 1.64; 95% c.i. 1.53 to 1.67), and open surgery (OR 1.76; 95% c.i. 1.64 to 1.92). However, patients with recurrent cholecystitis were older and had a higher ASA grade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early cholecystectomy for recurrent cholecystitis is associated with increased complication rates compared with first-time cholecystitis. These findings support early surgical intervention during the first episode to reduce the risk of adverse outcomes associated with recurrent disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraf166","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T12:44:00Z","timestamp":1765111440000},"source":"Crossref","is-referenced-by-count":0,"title":["Early cholecystectomy for recurrent\n                    <i>versus<\/i>\n                    first-time cholecystitis: nationwide population-based study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6559-9583","authenticated-orcid":false,"given":"Magnus","family":"Edblom","sequence":"first","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-4736","authenticated-orcid":false,"given":"Lars","family":"Enochsson","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]},{"name":"Division of Orthopaedics and Biotechnology, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Nystr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]},{"name":"Wallenberg Centre for Molecular Medicine, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-4951","authenticated-orcid":false,"given":"Gabriel","family":"Sandblom","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, Karolinska Institutet, S\u00f6dersjukhuset , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, S\u00f6dersjukhuset , Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urban","family":"Arnelo","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1732-168X","authenticated-orcid":false,"given":"Oskar","family":"Hemmingsson","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]},{"name":"Wallenberg Centre for Molecular Medicine, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Gkekas","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"2026021210332795500_zraf166-B1","first-page":"148","article-title":"The treatment of gallstone disease","volume":"117","author":"Gutt","year":"2020","journal-title":"Dtsch Arztebl Int"},{"key":"2026021210332795500_zraf166-B2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13017-020-00336-x","article-title":"2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis","volume":"15","author":"Pisano","year":"2020","journal-title":"World J Emerg Surg"},{"key":"2026021210332795500_zraf166-B3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jhbp.516","article-title":"Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis","volume":"25","author":"Okamoto","year":"2018","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"2026021210332795500_zraf166-B4","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1007\/s00464-003-9230-6","article-title":"Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial","volume":"18","author":"Kolla","year":"2004","journal-title":"Surg Endosc"},{"key":"2026021210332795500_zraf166-B5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.9738\/INTSURG-D-13-00068.1","article-title":"Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized 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cholecystitis: a population-based register study","volume":"47","author":"Popowicz","year":"2023","journal-title":"World J Surg"},{"key":"2026021210332795500_zraf166-B9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/TA.0b013e3182788e4d","article-title":"A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy","volume":"74","author":"de Mestral","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"key":"2026021210332795500_zraf166-B10","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s00464-016-5011-x","article-title":"Conservative treatment of acute cholecystitis: a systematic review and pooled analysis","volume":"31","author":"Loozen","year":"2017","journal-title":"Surg Endosc"},{"key":"2026021210332795500_zraf166-B11","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/0002-9610(80)90399-2","article-title":"Cholecystostomy: a place in modern biliary 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The importance of optimal timing of cholecystectomy in acute cholecystitis: data from the national Swedish registry for gallstone surgery, GallRiks","volume":"21","author":"Blohm","year":"2017","journal-title":"J Gastrointest Surg"},{"key":"2026021210332795500_zraf166-B17","doi-asserted-by":"crossref","first-page":"e6076948","DOI":"10.1155\/2018\/6076948","article-title":"Is nighttime really not the right time for a laparoscopic cholecystectomy?","volume":"2018","author":"Geraedts","year":"2018","journal-title":"Can J Gastroenterol Hepatol"},{"key":"2026021210332795500_zraf166-B18","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/bjs.11633","article-title":"Is out-of-hours cholecystectomy for acute cholecystitis associated with complications?","volume":"107","author":"Gustafsson","year":"2020","journal-title":"J Br Surg"},{"key":"2026021210332795500_zraf166-B19","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1159\/000496432","article-title":"Long-term impact of iatrogenic bile duct injury","volume":"37","author":"Schreuder","year":"2019","journal-title":"Dig Surg"},{"key":"2026021210332795500_zraf166-B20","doi-asserted-by":"crossref","first-page":"e30365","DOI":"10.1097\/MD.0000000000030365","article-title":"Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: a systematic review and meta-analysis","volume":"101","author":"Yang","year":"2022","journal-title":"Medicine"},{"key":"2026021210332795500_zraf166-B21","first-page":"CD008318","article-title":"Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. 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