Controlled Clinical Trial Comparing Early With Interval Cholecystectomy For Acute Cholecystitis

Abstract

The traditional management of acute Cholecystitis is initial conservative treatment with intravenous fluids, nasogastric suction, analgesic / antispasmotics, antibiotics and bed rest followed by elective surgery. Although early Cholecystectomy has been advocated but there is a school of thought strongly supporting the initial conservative treatment.This paper reports the result of such a trial in which 104 patients have been studied.

Of 44 patients managed conservatively, 4 patients had associated medical disease, 10 required urgent surgical intervention, because of failure of medical treatment, and two patients died.

Of 60 patients treated by early cholecystectomy, there were two patients with associated liver abscess: in one case it had burst in to the peritoneal cavity. Surgery was difficult in 10 cases. Cholecystectomy was possible in all Blood loss and times consumed were slightly more than in the interval cholecystectomy.