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Cholecystectomy in Acute Cholecystitis

Cholecystectomy in Acute Cholecystitis Abstract FOR OVER 30 years, surgeons have more and more frequently recommended early surgery in the treatment of acute cholecystitis and have preferred to remove the inflamed gallbladder at the time of surgery rather than drain it. Some surgeons and many physicians, however, continue to treat such patients medically or in a so-called conservative manner and undertake surgery only if signs of advancing inflammation develop. This conservative therapy may continue for many days before a decision is reached to remove or drain the gallbladder. Most surgeons also continue to advocate cholecystostomy in certain poor risk individuals or in those patients in whom cholecystectomy would be technically difficult. Our own preference has been to undertake immediate cholecystectomy in all patients with acute cholecystitis no matter what the patient's age or condition; we have almost never used cholecystostomy. A trial at medical or conservative therapy has its proponents, even among surgeons. Wright and References 1. Wright, H.K., and Holden, W.D.: The Risks of Emergency Surgery for Acute Cholecystitis , Arch Surg 81:341-347, 1960.Crossref 2. Hinshaw, D.B., and Carter, R.: Acute Obstructive Cholecystitis: Pathogenesis and Surgical Aspects , Amer J Surg 104:216-223, 1962.Crossref 3. McCubbrey, D., and Thieme, T.: In Defense of the Conservative Treatment for Acute Cholecystitis With an Evaluation of the Risk , Surgery 45:930-936, 1959. 4. Doubilet, H.; Reed, G.; and Mullholland, J.H.: Delayed Operative Management of Acute Cholecystitis , JAMA 155:1570, 1954.Crossref 5. Cole, W.H.: Recent Trends in Gallbladder Surgery , JAMA 150:631, 1952.Crossref 6. Bradham, R.R., and Nettles, G.S.: Cholecystostomy , Amer J Surg 104:821-824, 1962.Crossref 7. Becker, W.F.; Powell, J.; and Turner, R.: A Clinical Study of 1,060 Patients With Acute Cholecystitis , Surg Gynec Obstet 104:491-496, 1957. 8. Collins, D.L., and Thomson, F.B.: Cholecystostomy: Its Place in the Treatment of Acute Cholecystitis , Canad Med Assoc J 88:1267-1271, 1963. 9. Sparkman, R.S.: Planned Cholecystostomy , Ann Surg 149:746-759, 1959.Crossref 10. Glenn, F., and Thorbjarnarson, B.: The Surgical Treatment of Acute Cholecystitis , Surg Gynec Obstet 116:61-70, 1963. 11. Mahorner, H., and Becker, W.F.: Acute Cholecystitis: Optimal Time for and Extent of Operation , Amer Surg 27:347-353, 1961. 12. Wall, C.A., and Weiss, R.M.: Early Operation for Acute Cholecystitis , Arch Surg 77:433-438, 1958.Crossref 13. McEachern, C.G., and Sullivan, R.E.: Acute Cholecystitis , Arch Surg 78:300-303, 1959.Crossref 14. Horwitz, A.; McCorkle, R.J., Jr.; and Alpert, S.: Acute Cholecystitis: A Comparative Study of 60 Cases of Acute Cholecystitis Treated by Immediate Surgery and 60 Consecutive Cases Treated by Delayed Intervention , Med Ann D C 22:127-133, 1953. 15. Martin, W.L.: Management of Acute Cholecystitis , Postgrad Med 15:437-443, 1954. 16. Braasch, J.W.; Wheeler, W.M.; and Colcock, B.P.: Acute Cholecystitis , Surg Clin N Amer 44:707-716, 1964. 17. Sethi, R.S.: Surgical Management of Acute Cholecystitis: Analysis of 274 Cases , Arch Surg 82:366-372, 1961.Crossref 18. Byrne, S.J.: Acute Cholecystitis , Amer J Surg 97:156-172, 1959.Crossref 19. Crosby, V.G., and Ziffren, S.E.: Cholecystostomy as Definitive Therapy in the Aged With Acute Cholecystitis , J Amer Geriat Soc 13:496-500, 1965. 20. Hays, D.M., and Glenn, F.: The Fate of the Cholecystostomy Patient , J Amer Geriat Soc 3:21-30, 1955. 21. Glenn, F., and McSherny, C.K.: Etiological Factors in Fatal Complications Following Operations Upon the Biliary Tract , Ann Surg 157:695-706, 1963.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Cholecystectomy in Acute Cholecystitis

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320230037006
Publisher site
See Article on Publisher Site

Abstract

Abstract FOR OVER 30 years, surgeons have more and more frequently recommended early surgery in the treatment of acute cholecystitis and have preferred to remove the inflamed gallbladder at the time of surgery rather than drain it. Some surgeons and many physicians, however, continue to treat such patients medically or in a so-called conservative manner and undertake surgery only if signs of advancing inflammation develop. This conservative therapy may continue for many days before a decision is reached to remove or drain the gallbladder. Most surgeons also continue to advocate cholecystostomy in certain poor risk individuals or in those patients in whom cholecystectomy would be technically difficult. Our own preference has been to undertake immediate cholecystectomy in all patients with acute cholecystitis no matter what the patient's age or condition; we have almost never used cholecystostomy. A trial at medical or conservative therapy has its proponents, even among surgeons. Wright and References 1. Wright, H.K., and Holden, W.D.: The Risks of Emergency Surgery for Acute Cholecystitis , Arch Surg 81:341-347, 1960.Crossref 2. Hinshaw, D.B., and Carter, R.: Acute Obstructive Cholecystitis: Pathogenesis and Surgical Aspects , Amer J Surg 104:216-223, 1962.Crossref 3. McCubbrey, D., and Thieme, T.: In Defense of the Conservative Treatment for Acute Cholecystitis With an Evaluation of the Risk , Surgery 45:930-936, 1959. 4. Doubilet, H.; Reed, G.; and Mullholland, J.H.: Delayed Operative Management of Acute Cholecystitis , JAMA 155:1570, 1954.Crossref 5. Cole, W.H.: Recent Trends in Gallbladder Surgery , JAMA 150:631, 1952.Crossref 6. Bradham, R.R., and Nettles, G.S.: Cholecystostomy , Amer J Surg 104:821-824, 1962.Crossref 7. Becker, W.F.; Powell, J.; and Turner, R.: A Clinical Study of 1,060 Patients With Acute Cholecystitis , Surg Gynec Obstet 104:491-496, 1957. 8. Collins, D.L., and Thomson, F.B.: Cholecystostomy: Its Place in the Treatment of Acute Cholecystitis , Canad Med Assoc J 88:1267-1271, 1963. 9. Sparkman, R.S.: Planned Cholecystostomy , Ann Surg 149:746-759, 1959.Crossref 10. Glenn, F., and Thorbjarnarson, B.: The Surgical Treatment of Acute Cholecystitis , Surg Gynec Obstet 116:61-70, 1963. 11. Mahorner, H., and Becker, W.F.: Acute Cholecystitis: Optimal Time for and Extent of Operation , Amer Surg 27:347-353, 1961. 12. Wall, C.A., and Weiss, R.M.: Early Operation for Acute Cholecystitis , Arch Surg 77:433-438, 1958.Crossref 13. McEachern, C.G., and Sullivan, R.E.: Acute Cholecystitis , Arch Surg 78:300-303, 1959.Crossref 14. Horwitz, A.; McCorkle, R.J., Jr.; and Alpert, S.: Acute Cholecystitis: A Comparative Study of 60 Cases of Acute Cholecystitis Treated by Immediate Surgery and 60 Consecutive Cases Treated by Delayed Intervention , Med Ann D C 22:127-133, 1953. 15. Martin, W.L.: Management of Acute Cholecystitis , Postgrad Med 15:437-443, 1954. 16. Braasch, J.W.; Wheeler, W.M.; and Colcock, B.P.: Acute Cholecystitis , Surg Clin N Amer 44:707-716, 1964. 17. Sethi, R.S.: Surgical Management of Acute Cholecystitis: Analysis of 274 Cases , Arch Surg 82:366-372, 1961.Crossref 18. Byrne, S.J.: Acute Cholecystitis , Amer J Surg 97:156-172, 1959.Crossref 19. Crosby, V.G., and Ziffren, S.E.: Cholecystostomy as Definitive Therapy in the Aged With Acute Cholecystitis , J Amer Geriat Soc 13:496-500, 1965. 20. Hays, D.M., and Glenn, F.: The Fate of the Cholecystostomy Patient , J Amer Geriat Soc 3:21-30, 1955. 21. Glenn, F., and McSherny, C.K.: Etiological Factors in Fatal Complications Following Operations Upon the Biliary Tract , Ann Surg 157:695-706, 1963.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1966

References