Selective preoperative assessment before early laparoscopic cholecystectomy: A narrative review

Table 1 Guideline synthesis relevant to selective preoperative assessment

Guideline/source	Core recommendation	Relevance to selective assessment	Gap
NICE CG188 gallstone disease[1]	Supports definitive management with laparoscopic cholecystectomy and early surgery in acute presentations	Strengthens the argument that avoidable pathway delay matters	Does not specify anaesthetic clinic criteria
NICE NG45 preoperative tests[2]	Recommends selective testing based on surgical grade and comorbidity	Supports risk-based rather than universal investigation	Focuses on tests rather than full clinic attendance
WSES 2020 acute cholecystitis[3]	Supports early laparoscopic cholecystectomy when feasible	Aligns with streamlined access to surgery	Does not define pre-assessment omission criteria
Tokyo Guidelines 2018[4,5]	Provides severity grading and surgical management principles	Emphasises patient selection and safe cholecystectomy	Does not address direct-to-surgery assessment pathways
ASA preanaesthesia evaluation[10,11]	Evaluation should be appropriate to patient and procedure	Supports tailored evaluation and escalation	Requires local implementation detail
AUGIS acute gallstone pathway[9]	Promotes timely management of acute gallstone disease	Relevant to United Kingdom Hot Gallbladder Pathway design	Implementation varies by resources

ASA: American Society of Anesthesiologists.