Performing cholecystectomy at the same admission for patients with choledocholithiasis-associated cholangitis significantly lowers complications and readmissions.

• Same-admission cholecystectomy led to a 1.3% 30-day readmission rate versus 13.8% for deferred surgery (p=0.0023).
• Recurrence of biliary events was virtually eliminated (0%) in those treated same-admission compared to 56.5% in deferred cases (p<0.001).

Surgical delay poses increased risks, even in grade III cholangitis. Consider immediate surgery following clinical stabilization to improve outcomes.

• Deferred surgery was often due to perceived high surgical risk (21.3%) or patient preference (14.9%).