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When seriously ill patients with multiple comorbidities develop acute cholecystitis, clinicians must choose between cholecystectomy (CCY) or percutaneous cholecystostomy (PC). CCY is definitive but is associated with nontrivial postoperative morbidity in older or critically ill patients; PC might be better tolerated in the short term but leaves the patient vulnerable to ongoing complications. Unfortunately, no randomized trials have been performed to guide this choice.
Researchers conducted a retrospective review of these two procedures in the Boston Veterans Affairs Healthcare System. During 10 years, 150 CCYs and 51 PCs were performed for strictly defined acute cholecystitis; about half the PC patients eventually underwent CCY. As expected…