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Diagnosis and treatment of acute cholecystitis Acute cholecystitis is one of the most common acute surgical diseases. Typical clinical symptoms are pain in the upper abdomen, fever and leucocytosis. Ultrasonography may often be used to confirm the clinical diagnosis. There is a consensus that laparoscopic cholecystectomy is recommended as the treatment of choice and should be performed immediate after diagnosis independent of the onset of symptoms. The risk of complications is prevented by surgery. Surgery is the treatment of choice for acute cholecystits also in elderly patients with severe comorbidities. Conventional laparoscopic 3 - 4 port cholecystectomy is considered as a standard for removing the gallbladder. Laparoscopic cholecystectomy has become established as a safe standard procedure in the treatment of symptomatic cholecystolithiasis and cholecystitis with low mortality and morbidity. Nevertheless, this procedure is associated with typical complications. Bile duct injuries are among the most serious injuries. Most complications are the consequence of lack of experience or technical causes. By reasonably indication for laparoscopic cholecystectomy and a low inhibition rate of conversion, combined with adequate training (laparoscopy courses), the complication rate can be kept very low.