Early vs conservative treatment of acute cholecystitis. Personal experience and review of the literature [Trattamento in urgenza vs trattamento conservative della colecistite acuta: Nostra esperienza e stato dell'arte]

Aim. The aim of this retrospective study was to compare the results of early cholecystectomy and conservative treatment in acute cholecystitis. Methods. From January 1998 to December 2002, 134 patients were admitted to our Department with the diagnosis of acute cholecystitis. Eighty-nine patients (66%, Group 1) were cured with conservative treatment (i.e. fast, broad-spectrum antibiotics, fluid and analgesic drugs), 45 patients (34%, Group 2) were sumitted to early cholecystectomy. The 2 groups were matched for age, sex, laboratory results and echographic findings. Results. The morbidity was 32.5% in Group 1 versus 15.5% in Group 2 (p<0.05). Mean hospital stay was 18 days in Group 1 as compared to 10.5 days in Group 2 (p<0.05). At follow-Up (12 months) the mean period before starting again a normal working and social life was 57 days in Group 1 and 33 days in Group 2. Conclusion. The results of this study showed that early cholecystectomy was the gold standard in the treatment of acute cholecystitis, since it reduces morbidity, hospital stay and absence from working and social life in a statistically important way.