The improving results of cholecystectomy.

We reviewed the outcome of 389 consecutive patients undergoing cholecystectomy during the ten-year period from 1973 to 1983. Significant discrepancies between this series and other published data were noted as follows: Patients with acute cholecystitis, although older, had comparable morbidity and mortality rates with patients undergoing elective cholecystectomy. Diabetic and nondiabetic patients with acute cholecystitis had similar outcomes. In those patients with acute cholecystitis, delay in operation after hospital admission did not increase operative technical difficulties, morbidity, or length of postoperative hospitalization, although total hospitalization was prolonged. The histologic reports of gallbladder pathology in those patients with a clinical diagnosis of acute cholecystitis did not disclose acute inflammatory changes in 39% of cases, raising questions about the validity of previous reviews of patients with acute cholecystitis in which the microscopic diagnosis alone was used.