Please click here to view the full Cholecystectomy Commissioning Statement.

Commissioning Position

NHS Vale of York CCG will only commission elective referral into secondary care for a cholecystectomy assessment if the patient fulfils ANY of the criteria below:

• Symptomatic gallstones with a thickened gallbladder wall
• A dilated common bile duct on ultrasound
• Asymptomatic gallstones with abnormal liver function test (LFT) results
• Asymptomatic gall bladder polyp(s) reported on ultrasound
• Symptomatic gall bladder ‘sludge’ reported on ultrasound

Elective cholecystectomy surgery will only be commissioned where the patient fulfils ANY of the criteria below:

• Symptomatic gallstones
• Gall bladder polyp(s) larger than 8mm or growing rapidly
• Common bile duct stones
• Acute pancreatitis

AND The patient is fit for surgery.
NB: although this policy is not subject to NHS Vale of York CCG’s Health Optimisation thresholds patients should be encouraged by their GP and surgeon to lose weight prior to surgery and given appropriate support to address lifestyle factors that would improve their fitness for surgery and recovery afterwards.

GPs can refer patients for a surgical opinion whilst patients lose weight and surgeons (and anaesthetists) can consider the safety of surgery. There is a clinical balance between risk of surgical complications with obesity and with potential complications of gallstones whilst delaying surgery.

To submit an application to the CCG's Individual Funding Request Panel, please click here for further information.

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