What to choose from medical treatment, gallbladder drainage or cholecystectomy to treat acute cholecystitis

Abstract

The purpose of this study is to compare laparoscopic cholecystectomy with other treatment methods for acute cholecystitis at a university hospital. Treatments given to 197 patients with acute cholecystitis between 2016 and 2019 were examined. Three groups were set as first group of patients treated with interval cholecystectomy (n=107), second group of patients treated with early cholecystectomy (n=65) and third group of patients treated with gallbladder drainage (n=25). Demographic characteristics, hospitalization duration, laboratory results and ultrasonography findings obtained from patient files were statistically analysed. Among the 197 acute cholecystitis patients there was no significant difference between the groups in terms of initial laboratory findings. There were significant differences in terms of the gallbladder wall thickness, pericholecystic fluid collection and age and hospitalization duration between the 3 groups. No mortality was observed in these patients while one patient developed bilioenteric fistula and was treated. After the treatment of acute cholecystitis, the treatment approach should be decided according to response to medical treatment, comorbidities, surgical risk of patient, and radiological findings independent of the initial laboratory findings. In conclusion, it is suggested that clinicians to assess pericholecystic fluid for early intervention of the patient and gallbladder thickness to decide about gallbladder drainage for the treatment of the patient along with patient’s comorbidities.