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ACUTE CHOLECYSTITIS: AN APPRAISAL OF CURRENT METHODS OF TREATMENT
Author(s) -
Kune Gabriel A.,
Bieks David
Publication year - 1970
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1970.tb49946.x
Subject(s) - medicine , acute cholecystitis , cholecystitis , perforation , surgery , general surgery , gangrene , elective surgery , cholecystectomy , gallbladder , materials science , punching , metallurgy
An evaluation was made of the treatment of 302 patients presenting with acute cholecystitis over a six‐year period. Medical measures and resuscitation according to the patient's needs are the first line of treatment in all cases. Early surgical intervention is necessary when the complications of gangrene, pericholecystic abscess, or free perforation are present or suspected. Early surgery is also necessary if the diagnosis of acute cholecystitis is uncertain, and another acute abdominal condition which requires urgent surgery, such as a perforated peptic ulcer, cannot be excluded. Surgery is contraindicated for a small group of patients with uncomplicated acute cholecystitis because of their poor general medical condition. However, the majority of the patients have uncomplicated acute cholecystitis, they can be easily and quickly resuscitated, and they represent a reasonable surgical risk. In the past, it was customary in this group of cases to allow the attack to settle down and to operate subsequently on the patient at a time of election. It was found in the present series, as well as in other large recent series, that surgery could be safely performed during the attack of cholecystitis, and therefore during one hospital admission. The mortality and morbidity are not increased, and the hospital stay is significantly reduced when compared with patients who undergo surgery after the acute attack has settled down. This plan of treatment is applicable only if the surgeon who is undertaking the management of the patient is experienced In abdominal and biliary surgery.