[Topics in the surgical treatment of acute calculous cholecystitis]

A point is made in this paper in favour of early surgical action on cases of acute calculous cholecystitis, following an analysis of 140 patients who had undergone such operations through the past 13 years. Immediate surgery is a way to remove an obstructed inflammatory gallbladder even before severe complications can develop. Early cholecystectomy (within four days) was possible in 113 cases. Twenty-seven patients who had been admitted to hospital in the subacute phase of inflammation received conservative treatment. Yet, even here the operation, originally postponed, eventually had to be performed for progression of inflammation. Morphological changes to the gallbladders of those patients were much more severe, and technical conditions of their operations were more difficult than those experienced in early surgery. No-complication postoperative healing was recorded from 80.5 per cent of patients who had undergone early surgery and from eleven per cent of those whose operations had been postponed in the first place. The advantages of early surgery, within the first four days, were reflected also in the mortality rates which were 1.8 per cent in early surgery and 11.1 per cent for delayed operations.