Cholecystectomy in acute cholecystitis.

Of 130 patients admitted with acute cholecystitis, 100 were selected for a prospective study comparing the risks and benefits of early cholecystectomy versus initial conservative management followed by elective surgery. Comparative evaluation was carried out regarding operative difficulties and mishaps, postoperative complications, duration of hospitalization and compliance for surgery. Early cholecystectomy has advantage in terms of quick definitive treatment, completion of therapy in one hospital admission and salvage from serious complications of acute cholecystitis. Operative difficulties and mishaps and postoperative complications are comparable with delayed surgery. It obviates the danger of non-compliance by not reporting on the scheduled appointment. But it should be undertaken by an experienced surgeon and antibiotics should be administered prophylactically and following surgery to decrease the chances of septic complications. With these provisions it can be recommended as a treatment of choice for acute cholecystitis if the diagnosis can be established with confidence.