Acute Cholecystitis (Gallstones)

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Acute Cholecystitis (Gallstones): Treatment

Although cholecystitis may resolve spontaneously, surgery to remove the gallbladder (cholecystectomy) is usually needed when inflammation frequently persists or recurs. This operation is performed as soon as possible after the onset of cholecystitis, unless the patient is very ill, or if the inflammation is thought to have been present for many days.

Occasionally, in very ill patients, a tube can be placed through the skin to drain the gallbladder until the patient recovers from the acute illness and is fit to undergo surgery.

The operation performed to remove the gall bladder is called cholecystectomy. This operation is usually performed using a laparoscope. In this technique, small (1 cm) incisions are made in the abdomen, through which are passed instruments and a fiberoptic camera.

The operation is performed using these small instruments while the surgeon watches the image on a video monitor. Laparoscopic cholecystectomy results in less pain and shorter hospitalization times than an open operation. If there is a significant amount of inflammation, difficulty defining the anatomy, or if significant bleeding occurs, a laparoscopic operation may need to be converted to an open operation, performed through a larger incision.

Emergency surgery may be necessary if gangrene (tissue death), perforation, pancreatitis, or inflammation of the common bile duct occurs.

Nonsurgical treatment consists of pain control, antibiotics to eliminate the infection, and a low-fat diet when food is tolerated after the acute attack.