The surgical treatment of acute cholecystitis remains a controversial issue, but, as time goes on, it is being more widely accepted as the policy of choice.
In general, there are three views: (1) Early surgery should be undertaken shortly after the diagnosis is established and the electrolyte and fluid balance corrected, regardless of the time elapsed since the onset of the condition; (2) early operation should be performed only if the patient is seen early in the attack, but operation should be postponed and conservative treatment carried out for the patient seen 72 hours or later after the initiation of the acute attack, and (3) all patients should be treated conservatively, surgery being postponed either until the acute process subsides or until it is evident that perforation is imminent.
In recent years many surgeons have placed increased emphasis on the importance of early operation in acute cholecystitis. Early surgery should