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 .
Home treatment of patients with acute cholecystitis.
BACKGROUND Patients with acute cholecystitis are treated in Hospital . The aim of the study was to analyze the security and efficacy of treating not-operated-on patients with acute cholecystitis in Hospital in the Home ( HIH ) . METHODS Prospect i ve study from January 2010 to May 2011 including all patients diagnosed with acute cholecystitis , not operated on and without comorbidities admitted to HIH Unit from the Emergency Department Short Stay Unit and Observation Unit . Patients were treated with ertapenem for at least one week . Intravenous treatment was followed by oral therapy to complete 14 days of antibiotic treatment . Patient characteristics , clinical course , need for return to hospital during admission to HIH , and admission to hospital in the month after discharge from HIH are analyzed . RESULTS 25 patients were included . Mean age was 59 years ( 34 - 82 ) . Upon arrival to the Emergency Department , all patients suffered abdominal pain , 60 % had fever , and 32 % vomiting . 48 % of patients had a leukocyte count over 13,000 cells/μl . All patients had cholelithiasis and a distended gallbladder . 56 % showed thickening of the gallbladder wall . Fluid accumulation around the gallbladder was noted in 16 % of the cases . Murphy 's sign proved positive in 44 % . All patients showed a favorable course . No patient required hospital readmission during stay in HIH or in the month after discharge . All patients expressed their satisfaction with treatment at home . CONCLUSIONS Patients with acute cholecystitis and without comorbidities can be safely and effectively treated in HIH after a short monitoring period in hospital
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 .