[Surgical therapy of acute cholecystitis]

The active surgical approach obtains more and more importance in the therapy of acute cholecystitis. On the basis of an own retrospective examination over 10 years (1978 to 1987) with 342 cases of treatment and of the literature the various possibilities of the surgical therapy are described and assessed. On account of the possibilities of complication the treatment of the acute cholecystitis should on principle be performed at a hospital. According to the treatment of acute cholecystitis is differed between the immediate and early operation in the acute phase and the interval operation 2-3 months after the beginning of the disease. The early operation can further be subdivided into the principal early operation and the early operation for necessity in which the indication for the operation is made dependent on the development of the findings. The advantages of the early operation in contrast to the interval operation do not result from a smaller lethality, but among others from the avoidance of further complications, shorter times of complaint and treatment and lower costs. The interval operation and the only conservative therapy are still justified only in motivated exceptional cases.