Trends in management of acute cholecystitis

A retrospective review has been carried out of the management of acute cholecystitis in one hospital from 1974 to 1978. The policies and outcome are compared with those of the same centre during 1953-62. In the intervening period there has been a move towards early cholecystectomy. Overall mortality has fallen from 7.7% to 1.6%. The results of early surgery are comparable with those of delayed operations. The data also compare favourably with those of controlled clinical trials and support the adoption of early cholecystectomy for acute cholecystitis in routine practice. The saving of resources, however, may not be as great as is suggested by the results of clinical trials.