Decision-making process in long term acute cholecystitis.

OBJECTIVE: To demonstrate that the categorization of different therapeutic options is essential for the decision-making applied to clinical management. METHOD: This paper compares the usefulness of percutaneous echo-guided cholecystostomy as the first therapeutic option in acute long-term cholecystitis versus the exclusive surgical or clinical management. RESULT: We have analyzed the usefulness of different therapeutic options in a case of long term acute cholecystitis and we have obtained the following results: isolated intravenous antibiotic therapy (0.76), surgery (0.73) and echo-guided cholecystostomy (0.93). This last option has provided good clinical-radiological results. CONCLUSION: Decision trees are a good methodological option as support of surgical and non surgical therapeutic procedures.