Korean J Gastroenterol.  2018 May;71(5):264-268. 10.4166/kjg.2018.71.5.264.

Management of Acute Cholecystitis

• Lee SO
• Yim SK

• KMID: 2415484
• DOI: http://doi.org/10.4166/kjg.2018.71.5.264

Abstract

Acute cholecystitis is a common serious complication of gallstones. The reported mortality of acute cholecystitis is approximately 3%, but the rate increases with age or comorbidity of the patient. If appropriate treatment is delayed, complications can develop as a consequence with a grave prognosis. The current standard of care in acute cholecystitis is an early laparoscopic cholecystectomy with the appropriate administration of fluid, electrolyte, and antibiotics. On the other hand, the severity of the disease and patient's operational risk must be considered. In those with high operational risks, gall bladder drainage can be performed as an alternative. Currently percutaneous and endoscopic drainage are available and show clinical success in most cases. After recovering from acute cholecystitis, the patients who have undergone drainage should be considered for cholecystectomy as a definitive treatment. However, in elderly patients or patients with significant comorbidity, operational risks may still be high, making cholecystectomy inappropriate. In these patients, gallstone removal using the percutaneous tract or endoscopy may be considered.

Keyword

Cholecystitis, acute; Drainage; Cholecystectomy

MeSH Terms

Aged
Anti-Bacterial Agents
Cholecystectomy
Cholecystectomy, Laparoscopic
Cholecystitis, Acute*
Comorbidity
Drainage
Endoscopy
Gallstones
Hand
Humans
Mortality
Prognosis
Standard of Care
Urinary Bladder
Anti-Bacterial Agents

Reference

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