acute cholecystities - ng

[ArchivalUser]

patient comes with RUQ pain increased after meal fatty with increases wbc, fever. Pain started yesterday for first time after burger eating.
wht to do

- npo and analgesic

- emergent cholecystectomy

[ArchivalUser]

npo and analgesics

[ArchivalUser]

well kaplan says

if presents within 3 days go for lap.cholecystectomy

and if after 3 days let the GB cool with NPO and analgesics and later do cystectomy


---- wht does swanson say ?

[ArchivalUser]

okay,Swanson's is not very good for surgery so I Generally refer to CMDT for that.
As per CMDT - Acute cholecystitis will usually subside on a conservative regimen. Because of the high risk of recurrent attacks, cholecystectomy - generally laparoscopically - should generally be performed within 2-3 days after hospitalization (and immediately if perforation or gangrene is suspected0. If non surgical tt. has been elected,the pt. should be watched carefully for recurrent symptoms,evidence of gangrene of gall bladder, or cholangitis(charcoat's triad). Cholecystectomy is mandatory when there is evidence lof gangrene or perforation.

This is what I found..........would like to know the final consensus .......its confusing isn't it?

[ArchivalUser]

well so in this case on presentation within 3 days ....wht to choose betwwen these.

kaplan DVD step 3 says cholecystectomy. after 3 days cool down and then cholecystec.

need clarification on this

.....