Cholecystectomy for acute cholecystitis: timing of operation, bacteriologic aspects, and postoperative course

There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis. For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied. During the first period, there were two types of surgical intervention: during hospitalization after resolution of the acute episode, and during a second hospitalization 2 to 3 months later. During the second period, early cholecystectomy within 72 hours of the onset of symptoms became the option. Emergency operations did not reflect a surgical choice but rather conditions of necessity. The results of this study demonstrate that early cholecystectomy is preferred for a variety of reasons, the most important of these being a low incidence of positive results of bile culture in this phase, a negligible percentage of postoperative complications and mortality, and a short hospitalization period with resulting cost containment.