The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .
[Acute cholecystitis--early or delayed cholecystectomy].
INTRODUCTION In our population biliary tract diseases are the most frequent surgical entity . If the diagnosis of acute cholecystitis is relatively clear and the time from onset of the disease does not exceed 72 hours , early cholecystectomy is recommended . The aim of this prospect i ve study was to use certain analytical procedures in order to compare early and late results of early and delayed cholecystectomy . MATERIAL AND METHODS 240 patients were divided into two groups : Group I : patients treated by early cholecystectomy and Group II : patients treated by delayed cholecystectomy .  We compared the following : intraoperative findings , postoperative morbidity and mortality , complications , average number of patient-days and histopathological changes . RESULTS During the investigated period ( 1998 - 1999 ) , 599 ( 35.95 % ) patients with acute and 1.067 ( 64.05 % ) patients with chronic cholecystitis were treated at the Clinic of Abdominal and Endocrine Surgery of the Clinical Center Novi Sad . Out of 599 patients with acute cholecystitis , 489 ( 81.63 % ) patients underwent surgery , whereas 110 ( 18.37 % ) were treated conservatively . In regard to chronic cholecystitis , 963 ( 90.25 % ) patients were surgically treated , and 104 ( 9.75 % ) patients were conservatively treated . All patients from Group I were operated within 24 - 48 hours from onset of the disease or during 24 hours of hospitalization . They were hospitalized due to signs of cholecystitis for the first time , whereas this was the second hospitalization for all patients from Group II , 42 + /- 2.3 days after first hospitalization on average . Regarding sick leave in Group I patients it was calculated as follows : hospital days + home treatment and it made 32 + /- 3.7 days . In Group II it was calculated as follows : first hospitalization + home treatment + second hospitalization + home treatment making 53 + /- 6.7 days . CONCLUSIONS The number and type of early and late complications in Group II patients justifies early cholecystectomy ; in acute cholecystitis , cholecystectomy should be performed within 24 - 48 hours from the onset of the disease ; in regard to late , early cholecystectomies are characterized by significantly shorter period of recovery and sick leave
The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .