The CHOCOLATE multicentre clinical superiority trial randomised high-risk patients
with acute calculous cholecystitis (APACHE II score of 7 or more) to either laparoscopic cholecystectomy or percutaneous catheter drainage. The trial was
concluded early after a planned interim analysis. This study, published in the BMJ
, provides strong evidence that laparoscopic
cholecystectomy is superior to percutaneous catheter drainage in the treatment of high risk patients with acute calculous cholecystitis. Cholecystectomy not
only reduced the rate of major complications (ie, infectious and cardiopulmonary complications, or need for reintervention, or recurrent biliary disease), but also
reduced utilisation of healthcare resources and costs by more than 30 percent.