The goal of this clinical trial is to learn if performing gallbladder surgery early is as safe and effective as delaying it for people with acute cholecystitis (a sudden gallbladder infection). The main questions it aims to answer are:

• Do participants who have early surgery have a similar rate of complications compared to those who have delayed surgery?
• How does the timing of surgery affect the length of the hospital stay?

Researchers will compare two groups:

1. An early surgery group
2. A delayed surgery group

Participants in the early surgery group had their gallbladder removed within 72 hours of when their symptoms started. Participants in the delayed surgery group were first treated with medications and had their surgery 6-8 weeks later.

Inclusion Criteria:

• Yemeni nationals aged 18-70 years
• A clinical diagnosis of acute cholecystitis confirmed by clinical presentation, laboratory findings, and imaging studies
• Symptom duration of less than 72 hours at presentation
• Fitness for general anesthesia (American Society of Anesthesiologists [ASA] physical status classification I-III)
• Provision of written informed consent

Exclusion Criteria:

• Evidence of choledocholithiasis or acute cholangitis
• Severe comorbidities precluding surgery (ASA class IV-V)
• Coagulopathy (INR >1.5 or platelet count <100,000/μL)
• Pregnancy
• Previous major upper abdominal surgery
• Patient refusal to participate

De-identified individual participant data that underlie the results reported in this article, after publication. This includes data for all primary and secondary outcome measures. The study protocol will not be shared.

Data will be available beginning 3 months after article publication and the access period will remain open for 5 years.

Data will be made available to qualified researchers for meta-analysis or other secondary analyses consistent with the original aims of the study. Researchers must submit a methodologically sound proposal to the corresponding author at h.jowah@su.edu.ye. A signed data access agreement will be required prior to the release of any data.