Acute suppurative cholecystitis: a retrospective study of 173 cases.

Over a 14-year period we treated 2,290 cases of non-malignant biliary tract conditions, and among them were 173 cases of acute suppurative cholecystitis, an incidence of 7.6%. A correct preoperative diagnosis of acute suppurative cholecystitis was made in only about half the cases because features of recurrent pyogenic cholangitis dominated the clinical picture on many occasions. The diagnosis was confirmed in all cases at operation. Cholecystectomy (88%) was performed whenever this was found to be safe, and cholecystostomy (12%) was carried out only in poor-risk patients or when operative difficulties were encountered. The overall mortality of operation was 5.8%. Old age, preoperative shock, delay of operation and the presence of free perforation affected the prognosis adversely.