Purpose: Evidence-based guidelines recommend cholecystectomy during the index admission for mild acute biliary pancreatitis. In hospitals where patient throughput is paramount, it is often more expedient to book recovered patients for elective surgery. We sought to evaluate the outcomes of this practice in Tasmania. Methodology : A retrospective cohort study was conducted of patients with acute biliary pancreatitis between 2007 and 2018 using linked public hospital admissions and emergency department presentations, provided by the Tasmanian Data Linkage Unit. Patients were divided into two groups: early cholecystectomy (EC, during index admission), interval cholecystectomy (IC, after index admission). Results: The database included 3,503 pancreatitis patients, 1,008 were admitted for biliary pancreatitis. 289 patients were excluded due to having a prior or not documented cholecystectomy. Cholecystectomy was most commonly performed during the index admission (EC 409, IC 294 patients). 16 patients died during the index admission. Mean age was similar in each group (EC 54.3, IC 55.0 years). IC was associated with a longer total length of stay (8.0 vs 6.0 days, p=0.001). IC had a higher proportion of ICU admissions (17.3% vs 8.3%, p<0.001) and complications , including chronic pancreatitis (8.2% vs 4.4%, p=0.084) and pseudocysts (5.4% vs 1.5%, p=0.008). Conclusion : As with current guidelines, our results suggest clinical and cost benefits for patients undergoing index-admission cholecystectomy for acute biliary pancreatitis. Interval cholecystectomy should be reserved for patients with severe acute pancreatitis or other complications.