Management of Acute Cholecystitis

The role of surgical treatment in patients with acute cholecystitis was studied in (I) one hundred patients with acute cholecystitis who underwent cholecystectomy, (II) one hundred patients who underwent cholecystectomy for chronic cholecystitis for comparison and in (III) fifteen patients with acute cholecystitis treated by cholecystostomy. There were no deaths in Groups I and II and the incidence of complications was similar in the two groups. In contrast, patients in Group III had increased mortality, complications, and longer period of hospitalisation. Patients in Group III were also older, frequently had systemic disease and almost always had complications of acute cholecystitis. Our studies show that cholecystectomy is a safe procedure for the majority of patients with acute cholecystitis during their initial hospitalisation and avoids the risks of recurrent attacks and readmissions. Cholecystostomy has a place in treatment of the older patients with systemic disease and advanced local disease.