[Treatment for acute cholecystitis]

- This article provides an update on the current state of treatment in respect of acute cholecystitis. Several aspects are addressed such as the timing of, and approach to, cholecystectomy, the benefits and disadvantages of percutaneous gallbladder drainage, conservative treatment and the usefulness of antibiotic prophylaxis.- Early cholecystectomy is superior to delayed cholecystectomy as this is associated with fewer wound infections, shorter hospital stay, lower costs and greater patient satisfaction.- Radiological percutaneous drainage in the acute phase of cholecystitis is a procedure with high short-term success rates, but it appears to be associated with high rates of recurrent gallstone-related disease. A Dutch randomized multicentre study is currently investigating if high-risk patients benefit most from percutaneous drainage or from early cholecystectomy.- Postoperative antibiotic prophylaxis has not been proven useful in patients with mild- or moderately-severe acute cholecystitis. The usefulness of preoperative antibiotic prophylaxis is currently being studied.