Abstract
In most cases of acute cholecystitis early cholecystectomy is advisable even without progressive inflammation. If preconditions for a reliable early operation are not met or if the surgeon prefers to delay operation after the acute phase has passed, acute cholecystitis usually subsides with conservative treatment. In some cases, however, inflammation is progressive, spreads into the surrounding tissues and threatens perforation of the gallbladder. Causes for such evolution are stagnation and obstruction, virulence of infection and damage to the gallbladder wall by inflammation, pressure of stones, and gangrene from impaired blood supply. In particular diabetes and arteriosclerosis in elderly patients exert an adverse effect.
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Niederle, B.V. (1981). Biliary Emergencies. In: Niederle, B.V. (eds) Surgery of the Biliary Tract. Developments in Surgery, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-8213-0_11
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