An 87-year-old patient with a history of chronic bronchitis and heart failure has been diagnosed with acute calculous cholecystitis. After 4 days of hospitalization and treatment with absolute diet, piperacillin-tazobactam serum therapy, the patient continues with fever, persistent abdominal pain and leukocytosis. The most appropriate attitude at this time would be:
In this question, they insist on the age and comorbidity of the patient, as well as the time of evolution, so the answer will probably not be 1.  In any case, the ideal would be to drain the gallbladder that has not gone up again, so the answer I would give would be 2.
Urgent surgical treatment.
Biliary drainage by percutaneous cholecystostomy.
Replace piperacillin-tazobactam with metronidazole-cefotaxime.
Replace piperacillin-tazobactam with amikacin-clindamycin.
Add an aminoglycoside such as gentamicin to the treatment.
In this question, they insist on the age and comorbidity of the patient, as well as the time of evolution, so the answer will probably not be 1.
In any case, the ideal would be to drain the gallbladder that has not gone up again, so the answer I would give would be 2.