Treatment of cholecystitis: Cholecystostomy or cholecystectomy?

Nine hundred ninety-two consecutive patients with cholelithiasis and cholecystitis are reported on. In Finland, these diseases seem to affect women more often than men as only 18 per cent in the present series were men.The frequency of these diseases increases with advancing age and reaches its peak in patients sixty to sixty-five years of age.Therapy always consisted of cholecystectomy. The incidence of minor technical complications varied from 1.1 per cent in group I to 4.5 per cent in group III (6.1 per cent in group IIB). Postoperative nonfatal complications varied from 2.0 per cent in group I to 5.2 per cent in group III (8.1 per cent in group IIB).The age-adjusted duration of postoperative hospitalization was about eight days (in group IIB, nine days). In groups I and II one patient died whereas in group III two died. The mortality varied from 0.2 per cent in group I to 0.6 per cent in group III (1.2 per cent in group IIB). The overall mortality for this series was 0.5 per cent.On the basis of this analysis and the good results, I have concluded that cholecystectomy is the preferred therapy for cholecystitis at all stages when all coexisting diseases and water and electrolyte imbalances have been treated.