title: Gallstones: best served hot.
abstract: BACKGROUND
  Acute episodes of gallstone-related diseases have traditionally been managed conservatively. In the event of gallstones obstructing the common bile duct, patients had endoscopic extraction of calculi with interval cholecystectomy after 4 weeks to 6 weeks when acute inflammatory changes have subsided. This placed the patient at risk of recurrent cholecystitis, pancreatitis, or other complications of cholelithiasis.
  
  
  METHODS
  Patients presenting with acute gallstone-related diseases were investigated and underwent laparoscopic cholecystectomy during the same admission according to a predetermined treatment protocol.
  
  
  RESULTS
  All patients (119) treated according to the study protocol had good results, with no 30-day mortality and no biliary tract injuries. One patient had bleeding from the cystic artery, and 6 patients required conversion to open cholecystectomy.
  
  
  CONCLUSIONS
  Growing expertise in laparoscopic cholecystectomy has made it possible for surgeons to perform safe cholecystectomy in the presence of acute gallstone-related disease. Our experience of managing gallstone disease with prompt cholecystectomy during the index admission shows that this approach provides better, safer, and more cost-effective patient care.
authors.affiliation: Department of Surgery, The Princess Royal University Hospital, Farnborough Common, Orpington, Kent, United Kingdom. tasneemtarun@hotmail.com
authors.forename: Tarun
authors.initials: T
authors.lastname: Singhal
authors.forename: Santosh
authors.initials: S
authors.lastname: Balakrishnan
authors.forename: Starlene
authors.initials: S
authors.lastname: Grandy-Smith
authors.forename: John
authors.initials: J
authors.lastname: Hunt
authors.forename: Maxwell
authors.initials: M
authors.lastname: Asante
authors.forename: Shamsi
authors.initials: S
authors.lastname: El-Hasani
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome