[Laparoscopic cholecystectomy and percutaneous echo-guided cholecystostomy. Their applications in acute cholecystitis]. / Colecistectomia laparoscopica e colecistostomia percutanea ecoguidata. Applicazioni nella colecistite acuta.

ABSTRACT

Laparoscopic cholecystectomy is nowadays proposed as elective treatment in acute cholecystitis; the advantages obtained with this method are comparable with those of laparoscopic cholecystectomy outside inflammatory complications. Moreover in emergency we have the advantage of better diagnostic definition and less surgical trauma. When acute cholecystitis affects high risk patients from the anesthesiologic view percutaneous US-assisted cholecystostomy is considered more valuable than the medical conservative treatment. Drainage of gallbladder is followed from a dramatic clinical improvement with more time for a laparoscopic cholecystectomy or for a percutaneous lithotripsy or eventually for the simple withdrawal of the catheter.