Acute care surgical model is one way to manage acute cholecystitis (Re: ANZ J. Surg. 2010; 80: 438-42).

摘要

Lehane and colleagues should be commended for reminding readers of the importance of striving for improvements in quality of care for surgical patients. It should come as no surprise that early assessment of patients by experienced surgeons, early access to theatre and carefully supervised surgery should lead to better outcomes but the demonstration and measurement of this improvement from a quality perspective continues to be difficult. Many centres have reported on the safety and efficacy of early surgery for acute cholecystitis and this approach should be considered the 'gold standard'. These arguments have been summarized in a recent Cochrane review. The premise therefore, put forward by the authors that acute cholecystitis can be treated after a 6-week delay, is outdated and not in line with current management guidelines for most specialist hepatopancreatobiliary (HPB) units.