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There has been a rising incidence of small renal masses and concomitant downward stage migration. This has led to an evolution in the management of kidney cancer from radical nephrectomy to nephron-sparing treatment options including observation. The adoption of partial nephrectomy continues to increase but is still incomplete leading to significant disparities in the delivery of care throughout the country. Surgical excision remains the treatment of choice for small kidney cancers; however, ablative therapies and active surveillance are emerging as reasonable options for select patients. With continued refinements in treatment options and improvements in ability to risk stratify SRMs, the current treatment trends will likely continue to evolve.

The role of percutaneous cholecystostomy (PC) or laparoscopic cholecystectomy (LC) in the management of patients with acute cholecystitis presenting beyond 72 hours from the onset of symptoms is unclear and undefined. The aim of this study was to examine and compare the outcomes of PC or LC in the management of these patients, who failed 24 hours of initial nonoperative management.