Training vs practice: A tale of opposition in acute cholecystitis

Core Tip

Core tip: General surgeons commonly perform laparoscopic cholecystectomy for acute cholecystitis; however, current practices in biliary surgery often vary regarding timing, intraoperative biliary imaging, and management of bile duct stones. In spite of growing evidence in the literature defining best practice and societal guidelines supporting early cholecystectomy, intraoperative cholangiogram and ultrasound, and laparoscopic bile duct exploration utilizing laparoscopic ultrasound and performing common bile duct exploration, an overwhelming number of surgeons still perform delayed operations, rarely perform intraoperative imaging and defer treatment of common bile duct stones. Efforts should be made to adopt the evidence-based data supported in the literature.