[Acute cholecystitis: elements for diagnosis and therapy].

The Authors report their experience in the surgical management of 439 patients with acute cholecystitis. Symptoms and laboratory findings at onset, preoperative diagnostic tools, associated disorders, surgical procedures as well as age-related postoperative morbidity and mortality and length of postoperative stay were analyzed. The most valuable investigation in the diagnosis of acute cholecystitis was ultrasound carried within the first 48 hrs, with positive results in 81% of cases. Tc-99m-HIDA biliary tract imaging proved to be a rapid, highly sensitive and specific, non invasive method of diagnosing acute cholecystitis in doubt cases. Morbidity (4.8%) and mortality (0%) rates in younger patients were inferior than those (22% vs 1.5%) observed in the elderly. Early and late results indicate that early cholecystectomy is the treatment of choice in acute cholecystitis.