Timing of surgery in acute cholecystitis.

Eighty-one cases of cholecystectomy performed over a period of 12 months were reviewed. Those operated upon acutely, those operated upon electively, and those initially treated in the hospital before surgery was performed were compared with regards to the length of hospital stay, injury to the common bile duct, wound infection and mortality rate. There is no significant difference in the mortality rate, but the rate of wound infection 23%, and injury to the common bile duct (17.95%) are highest in those operated upon acutely. It would seem as if the "delayed" surgery, that is, conservative treatment for about a week to two in the hospital before surgery, is preferred if common bile duct exploration or a choledocho-enterostomy is anticipated.