Selective preoperative assessment before early laparoscopic cholecystectomy: A narrative review

Table 3 Objective findings and limitations of the illustrative United Kingdom Hot Gallbladder Pathway service evaluation

Aspect	Objective finding or interpretation
Cohort	511 adults undergoing laparoscopic cholecystectomy, January 2020-January 2025
Risk distribution	401 ASA I-II (78.5%); 110 ASA III-IV (21.5%)
Assessment pathway	334 (65.4%) without formal clinic-based pre-assessment; 177 (34.6%) with formal assessment; all ASA III-IV patients formally assessed
Recorded outcomes	No anaesthetic-related adverse event identified; one cancellation (0.2%), unrelated to anaesthetic factors
Interpretation	Supports feasibility in a selected cohort; does not establish equivalence or safety for rare events
Unmeasured outcomes	Waiting time, attributable recurrent admission, patient-reported outcomes and cost-effectiveness
Key limitations	Retrospective, single-trust, clinician-selected, potential ASA misclassification and rare-event underpowering

ASA: American Society of Anesthesiologists.