What criteria should I use to refer a patient with gallstone-related complications to secondary care?

Referral criteria for patients with gallstone-related complications to secondary care include:

• Emergency admission for any person aged 18 or over who is systemically unwell with suspected complications such as acute cholecystitis, cholangitis, or pancreatitis ¹.
• Urgent referral to gastroenterology or surgical services with biliary expertise for people with known gallstones and jaundice, or clinical suspicion of biliary obstruction indicated by significantly abnormal liver function tests ¹.
• Referral of all patients diagnosed with symptomatic gallstone disease to a surgeon for consideration of laparoscopic cholecystectomy, with urgency based on clinical judgement ¹.
• Hospital admission for suspected acute cholecystitis to confirm diagnosis, monitor clinical status, and initiate treatment including intravenous fluids, antibiotics, analgesia, and surgical assessment for cholecystectomy ².
• Referral for bile duct clearance and laparoscopic cholecystectomy in patients with symptomatic or asymptomatic common bile duct stones due to risk of serious complications such as cholangitis or pancreatitis ¹,³.
• Consideration of percutaneous cholecystostomy for gallbladder empyema when surgery is contraindicated and conservative management fails ³.
• Emergency referral if pain from gallstone disease cannot be managed in primary care ¹.