IV fluids, NG tube, and antibiotics: Correct

This is the correct initial management of acute cholecystitis. IV fluids should be started in order to hydrate the patient and correct any electrolyte abnormalities. NG decompression of the stomach is done if the patient has been vomiting. For acute cholecystitis of average severity, parenteral cefazolin should be given. Parenteral penicillin, clindamycin, and an aminoglycoside should be given for severe disease. Most patients will begin to show improvement with this treatment within a few hours. If the patient's condition worsens significantly emergent treatment may be necessary.

The patient is begun on IV fluids, a NG tube is placed, and antibiotics are started. Within a couple of hours she begins to show some improvement in the pain without any analgesics. What is your next step in management?

Discharge patient and plan for an elective cholecystectomy in six weeks
Perform an urgent open cholecystectomy
Plan for a cholecystectomy within the next day or two
Perform percutaneous aspiration of stone
Begin shock-wave lithotripsy