Correlations between anatomic and clinical findings were absent in a series of 214 cases of acute cholecystitis, and there was a high percentage of severe forms (58 p. 100). Early operation (between 48 and 72 hours) is therefore the most logical treatment and demonstrates comparable morbidity and mortality, if not lower figures, than with delayed surgery. Diagnosis can usually be made on clinical grounds and results of ultra-sound imaging and allows surgery to be performed after intensive care and preoperative antibiotic therapy. Total surgery with perioperative cholangiography is usually possible (95 p. 100 cases).