Scoring System in Acute Calculous Cholecystitis
Scoring System in Acute Calculous Cholecystitis
Acute cholecystitis is a common disease in the daily practice of general surgery. There are
 various methods in the treatment of this disease, such as early cholecystectomy, medical
 treatment, six weeks later cholecystectomy and cholecystostomy. However, it is not satisfied
 with objective criteria that these methods are selected according to which patient groups.
 With this observational-prospective study, the benefit of first visit scoring on 'which of
 the treatment options will be most suitable for the patient' will be investigated. Thus, rare
 but severe complications of cholecystectomy can be prevented.
Acute cholecystitis refers to acute inflammation of the gallbladder, and why it is often
 gallstones. Gallstones are seen in western society with about 10% frequency, while 80% of
 them are asymptomatic. Acute cholecystitis accounts for 1-3% of those with symptomatic
 gallstones.

 Acute cholecystitis is a table characterized by right upper quadrant pain (in the
 inflammatory pain pattern and continuous), defensiveness in the right upper quadrant (murphy
 manifestation is positive or not), and an increase in inflammatory response parameters (such
 as fever, white blood cell, and CRP elevation). Biliary scintigraphy, called the HIDA scan,
 is the gold standard method in diagnosis. However, due to the difficulty and cost of
 application, ultrasonography is used in the routine application in diagnosis. It is valuable
 that gallstones and gallbladder walls are thicker than 4 mm in ultrasonography. However,
 pericholecystic fluid is a more valuable finding and is rare.

 In the treatment of acute cholecystitis, the patient's hospitalization, limiting oral food
 intake, IV hydration, NSAID, and antibiotic treatment is the main conservative approaches.
 While these patients were admitted to the hospital in the first 72 hours from the onset of
 symptoms, early cholecystectomy is recommended. If they arrive later, interval
 cholecystectomy is recommended after 6-8 weeks. Laparoscopic cholecystectomy is recommended
 for all operations. However, the choice of surgical treatment is determined by the surgeon,
 according to the patient. More precise and objective criteria are needed to contribute to
 this choice.

 In a study comparing early cholecystectomy and delayed cholecystectomy, intraoperative and
 postoperative complications were more common in early cholecystectomy than interval
 cholecystectomy. Still, early cholecystectomy had better results in terms of cost and
 hospital stay. There are many studies in the literature comparing early and late
 cholecystectomy. In these studies, the selection criteria of patients are different in all of
 them.

 Finally, it was emphasized that a retrospective scoring study conducted in Germany could be
 successful in patient selection.

 In conclusion, the debate on treatment choices of patients with acute cholecystitis
 continues. Recent publications in the literature on the development of scoring systems for
 these patients draw attention, so investigators want to investigate the effectiveness of a
 scoring system in which patients are evaluated in many ways.
Inclusion Criteria:

 -  Clinically and Radiologically diagnosed with acute cholecystitis

 -  be over 18 years old

 Exclusion Criteria:

 -  Being under the age of 18

 -  getting pregnant

 -  Acute pancreatitis, cholangitis or choledochal stone with acute cholecystitis

 -  Having a previous history of upper abdominal surgery