During the period 1980 to 1989, 342 patients with acute cholecystitis, 202 women and 140 men, with median age 71 (19-100) years, were admitted to our department. The treatment strategy during the period was early planned cholecystectomy in operable stabile patients with a duration of the disease of less than 7-8 days. Seven patients (2.0%) died, three after emergency operation, three after delayed operation when conservative treatment had failed, and one after medical treatment only. None of 192 patients treated with early planned operation died, and there was no lethality among the patients below the age of 75. The stay in hospital was reduced by 5.2 days after early planned operation. Early planned cholecystectomy for acute cholecystitis is a safe and cost-effective treatment.