[Immediate or interval operation of acute cholecystitis in patients over 70].

Among 1372 cholecystectomies there were 152 patients suffering from acute cholecystitis. 54 patients were over 70 years of age. On suspecting a free or covered perforation surgery took place immediately (11 patients). In case of rapidly progressing abdominal symptoms during the first 48 hours these patients also underwent surgery (17 patients): 6 patients came to death (mortality rate: 21%). In the beginning 50 patients were treated conservatively without any positive result in more than half of the patients because the inflammation in the stone-filled gallbladder could not be brought to a standstill. 15 patients had a delayed cholecystectomy within the first 3 weeks after the onset of symptoms and 11 patients within the first 3 months. The outcome of these delayed operations was infavourable. Therefore, we recommend the early operation as far as patients over 70 years are concerned.