Discussion Conservative treatment of acute calculous cholecystitis during index admission seems feasible and safe , especially in patients with mild disease .
Background In medical practice , the tendency to remove an inflamed gallbladder is deeply rooted .
Cholecystectomy , however , is associated with relatively high complication rates , and therefore the decision whether or not to perform surgery should be well considered .
For some patients , the surgical risk – benefit profile may favour conservative treatment .
The objective of this study was to examine the short- and long-term outcome of conservative treatment of patients with acute calculous cholecystitis .
Long-term follow-up of a randomized controlled trial of observation versus surgery for acute cholecystitis: Non-operative management is an option in some patients
Abstract Background . Cholecystectomy is routinely recommended to prevent recurrent disease after an initial episode of acute cholecystitis . Therefore , r and omized controlled trials have mainly focused on the timing of surgery , but many patients scheduled for cholecystectomy have deferred surgery with long periods of symptom-free intervals . Our present aim is to examine the long-term feasibility and safety of observation compared with surgery . Methods . Trial of 64 patients with acute cholecystitis previously r and omized to observation or cholecystectomy  , which examined outcome in terms of completed r and omized treatment and appearance of further symptoms and the need for surgical treatment .  Thirty-three patients were r and omized to observation and 31 patients to cholecystectomy .  Median follow-up was 14 years . Results . Of the 33 patients r and omized to observation , 11 ( 33 % ) experienced a new event of gallstone-related disease ( eight ( 24.2 % ) had acute cholecystitis ) and 11 ( 33 % ) were operated . No significant difference ( p = 0.565 ) was found between the two r and omized groups with regard to recurrent disease or complications . Virtually no surgery took place after 5 years of follow-up . The difference in completed r and omized treatment between the groups was not significant ( p = 0.077 ) . Long-term mortality was equal in those operated and in those observed . Conclusions . Twenty-four percent of the patients experienced recurrent cholecystitis , but escalation of disease severity or increased mortality was not observed . Long-term observation after acute cholecystitis was feasible in two-thirds of the patients as the risk for recurrent disease was negligible after 5 years
Discussion Conservative treatment of acute calculous cholecystitis during index admission seems feasible and safe , especially in patients with mild disease .
Background In medical practice , the tendency to remove an inflamed gallbladder is deeply rooted .
Cholecystectomy , however , is associated with relatively high complication rates , and therefore the decision whether or not to perform surgery should be well considered .
For some patients , the surgical risk – benefit profile may favour conservative treatment .
The objective of this study was to examine the short- and long-term outcome of conservative treatment of patients with acute calculous cholecystitis .