Subtotal cholecystectomy versus cholecystostomy

Emergency laparoscopic cholecystectomy (LC) is associated with a higher morbidity and mortality, as compared to elective LC. A two-fold increase in 30-day re-admission after LC was associated with two or more pre-operative admissions with symptoms of cholecystitis, as opposed to index-admission-LC (IALC). This was presumably because of more inflammation due to repeated attacks of cholecystitis in the former cohort, making gallbladders more "difficult". Inflamed gallbladders with higher Nassar-scores (scores 3 and 4) also have significantly raised complication rates.