Decision-making process in long term acute cholecystitis.
OBJECTIVE
To demonstrate that the categorization of different therapeutic options is essential for the decision-making applied to clinical management.


METHODS
This paper compares the usefulness of percutaneous echo-guided cholecystostomy as the first therapeutic option in acute long-term cholecystitis versus the exclusive surgical or clinical management.


RESULTS
We have analyzed the usefulness of different therapeutic options in a case of long term acute cholecystitis and we have obtained the following results: isolated intravenous antibiotic therapy (0.76), surgery (0.73) and echo-guided cholecystostomy (0.93). This last option has provided good clinical-radiological results.


CONCLUSIONS
Decision trees are a good methodological option as support of surgical and non surgical therapeutic procedures.
Córdoba Díaz de Laspra
E
E
General Surgery Department, Universitary Miguel Servet Hospital, Saragosa, Spain. ecordoba@arrakis.es
Ceballos Alonso
C
C
Artigas Martín
J M
JM
Artal Cortés
A
A
del Río Marco
F J
FJ
D000208:Acute Disease; D002764:Cholecystitis / Q000628:therapy*; D002767:Cholecystostomy; D003657:Decision Making; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors