[Acute cholecystitis. Requirement for different therapies in younger and old patients]

The results are compared of early operation (within 48 h of the onset of symptoms), postponed early operation, and late operation in 467 patients with acute cholecystitis. Treatment of acute cholecystitis is usually surgical and radical sanitation of gallbladder and bile ducts should be done during the first in-patient treatment. For patients under 60 years of age truly early operation is preferable. It can be practised with minimal risk and allows bile duct interventions to be extended. Immediate operation improves the chance of survival (86%) particularly in patients with perforations. In patients over 60 years of age intensive antibiotical and general preoperative treatment should be carried out until the acute inflammatory symptoms fade and postponed early operation is performed. The lethality of patients having undergone preoperative treatment is 1% and that of other patients is 10%.