Acute cholecystitis.
BACKGROUND
Of people admitted to hospital for biliary tract disease, 20% have acute cholecystitis. Up to the age of 50 years, acute calculous cholecystitis is three times more common in women than in men, and about 1.5 times more common in women than in men thereafter. About 95% of people with acute cholecystitis have gallstones. Optimal therapy for acute cholecystitis, based on timing and severity of presentation, remains controversial.


METHODS
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute cholecystitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: early cholecystectomy, laparoscopic cholecystectomy, minilaparoscopic cholecystectomy, observation alone, and open cholecystectomy.
Fialkowski
Elizabeth
E
Washington University School of Medicine, Washington, USA.
Halpin
Valerie
V
Whinney
Robb R
RR
D000208:Acute Disease; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery; D041881:Cholecystitis, Acute / Q000601:surgery; D042882:Gallstones / Q000601:surgery; D006760:Hospitalization; D006801:Humans; D012720:Severity of Illness Index; D016896:Treatment Outcome