NBME Surgery Shelf Practice Test

In stable patients with acute cholecystitis, removing the gallbladder promptly is the preferred definitive treatment. Performing laparoscopic cholecystectomy within about 72 hours of presentation has been shown to shorten overall hospital stay, reduce the risk of recurrent biliary symptoms, and avoid the complications that can occur if surgery is delayed. The inflamed gallbladder can still be safely dissected early in most patients, whereas delaying surgery—such as waiting weeks—leads to recurrent attacks and may make later surgery more challenging with higher complication rates. Endoscopic stone extraction addresses stones in the common bile duct but does not treat the inflamed gallbladder itself, so it’s not the definitive management for acute cholecystitis. Therefore, the best approach in stable patients is to perform early cholecystectomy within 72 hours.