Treatment of cholecystitis: cholecystostomy or cholecystectomy?

Nine hundred ninety-two consecutive patients with cholelithiasis and cholecystitis are reported on. In Finland, these diseases seem to affect women more often than men as only 18% in the present series were men. The frequency of these diseases increases with advancing age and reaches its peak in patients sixty to sixty-five years of age. Therapy always consisted of cholecystectomy. The incidence of minor technical complications varied from 1.1% in group I to 4.5% in group III (6.1% in group IIB). Postoperative nonfatal complications varied from 2.0% in group I to 5.2% in group III (8.1% in group IIB). The age-adjusted duration of postoperative hospitalization was about eight days (in group IIB, nine days. In groups I and II one patient died whereas in group III two died. The mortality varied from 0.2% in group I to 0.6% in group III (1.2% in group IIB). The overall mortality for this series was 0.5%. On the basis of this analysis and the good results, I have concluded that cholecystectomy is the preferred therapy for cholecystitis at all stages when all coexisting diseases and water and elctrolyte imbalances have been treated.