Early operation for acute cholecystitis.

It is well established that the ideal method of management for acute cholecystitis is removal of the diseased gallbladder. However, controversy still exists as to the best time for operation and the extent of the operative procedure during the phase of acute inflammation. The controversy may be brought into focus by certain questions. First, is there an optimum period of time that should elapse from the onset of symptoms of acute cholecystitis to removal of the diseased gallbladder? This is to say, when during the acute phase may cholecystectomy be accomplished efficiently and expeditiously, with minimal morbidity and negligible mortality? Second, with present advancements in surgery, is it still necessary to "stage" the operative procedures incident to removal of the inflamed gallbladder? This question brings up the relative merits of cholecystostomy and cholecystectomy, which have been thoroughly discussed in many publications. 5-10 Moreover, it includes the problem of common-duct exploration