Materiały źródłowe

• #1 Cholecystitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/diagnosis-treatment/drc-20364895

  Endoscopic retrograde cholangiopancreatography (ERCP) uses a dye to highlight the bile ducts on X-ray images. A thin, flexible tube with a camera on the end, called an endoscope, goes through the throat and into the small intestine. The dye enters the ducts through a small hollow tube, called a catheter, passed through the endoscope. Tiny tools passed through the catheter also can be used to remove gallstones. […] Treatment for cholecystitis most often involves a hospital stay to control the swelling and irritation, called inflammation, in your gallbladder. Sometimes, surgery is needed. […] At the hospital, treatments to control your symptoms may include: Fasting. You may not be able to eat or drink at first to take stress off your inflamed gallbladder. […] Antibiotics to fight infection. You might need these if your gallbladder is infected.

• #2 Cholecystitis (Gallbladder Inflammation): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15265-gallbladder-swelling–inflammation-cholecystitis

  Cholecystitis is treated immediately in the hospital. Treatment begins with supportive care, including: […] The definitive treatment for cholecystitis is surgery to remove your gallbladder. […] If youre delaying or foregoing surgery, you might have: […] Endoscopic gallstone removal. Endoscopic retrograde cholangiopancreatography (ERCP) is another nonsurgical procedure that combines an upper endoscopy with X-ray technology to visualize your biliary system. […] To prevent the effects of repeat episodes of gallbladder inflammation, healthcare providers recommend surgery to remove your gallbladder (cholecystectomy). […] Your biliary and digestive systems can function well without your gallbladder. […] You’ll need treatment in the hospital for cholecystitis, regardless of the type or cause. The hospital can provide immediate pain relief while they look for the cause. […] In most cases, healthcare providers recommend definitive treatment with surgery.

• #3 Acute Cholecystitis Treatment & Management: Approach Considerations, Initial Therapy and Antibiotic Treatment, Conservative Treatment of Uncomplicated Cholecystitis

  https://emedicine.medscape.com/article/171886-treatment

  Treatment of acute cholecystitis depends on the severity of the condition and the presence or absence of complications. Uncomplicated cases can often be treated on an outpatient basis; complicated cases may necessitate a surgical approach. […] In patients who are unstable, percutaneous transhepatic cholecystostomy drainage may be appropriate. Antibiotics may be given to manage infection. Definitive therapy involves cholecystectomy or placement of a drainage device; therefore, consultation with a surgeon is warranted. Consultation with a gastroenterologist for consideration of endoscopic retrograde cholangiopancreatography (ERCP) may also be appropriate if concern exists about the presence of choledocholithiasis. […] In acute cholecystitis, the initial treatment includes bowel rest, intravenous hydration, correction of electrolyte abnormalities, analgesia, and intravenous antibiotics. For mild cases of acute cholecystitis, antibiotic therapy with a single broad-spectrum antibiotic is adequate.

• #4 Acute cholecystitis

  https://www.nhs.uk/conditions/acute-cholecystitis/

  Acute cholecystitis is potentially serious because of the risk of complications. […] It usually needs to be treated in hospital with rest, intravenous fluids and antibiotics. […] If you’re diagnosed with acute cholecystitis, you’ll probably need to be admitted to hospital for treatment. […] Initial treatment will usually involve: not eating or drinking (fasting) to take the strain off your gallbladder, receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration, taking medicine to relieve your pain. […] You’ll also be given antibiotics if it’s thought you have an infection. […] Removing your gallbladder may be recommended at some point after initial treatment to prevent acute cholecystitis coming back and reduce your risk of developing potentially serious complications. […] This type of surgery is known as a cholecystectomy. […] If surgery is not an option, you may be offered a procedure to drain away the fluid that has collected in your gallbladder.

• #5 Acute cholecystitis

  https://www2.hse.ie/conditions/acute-cholecystitis/

  Acute cholecystitis is serious because of the risk of complications. It usually needs treatment in a hospital with rest, intravenous (through a drip into a vein) fluids and antibiotics. […] If you have acute cholecystitis, you will need to go to hospital for treatment. […] Initial treatment usually involves: fasting (not eating or drinking) to take the strain off your gallbladder, receiving intravenous (through a drip into a vein) fluids to prevent dehydration, taking medicine for your pain. […] You’ll also be given antibiotics if you have an infection. […] After initial treatment, you may need your gallbladder removed. This prevents acute cholecystitis from coming back. It also reduces your risk of developing serious complications.

• #6 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Treatment usually involves antibiotics and cholecystectomy. […] Management includes hospital admission, IV fluids, and analgesics, such as a nonsteroidal anti-inflammatory drug (NSAID; ketorolac) or opioid. […] Parenteral antibiotics are usually initiated to treat possible infection, but evidence of benefit is lacking. […] Cholecystectomy cures acute cholecystitis and relieves biliary pain. […] Early cholecystectomy is generally preferred, best done during the first 24 to 48 hours in the following situations: The diagnosis is clear and patients are at low surgical risk. […] Treat patients with IV fluids, antibiotics, and analgesics; do cholecystectomy when patients are stable.

• #7 Acute Cholecystitis Medication: Antiemetics, Analgesics, Antibiotics

  https://emedicine.medscape.com/article/171886-medication

  The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Agents used in patients with cholecystitis include antiemetics, analgesics, and antibiotics. […] Treatment of cholecystitis with antibiotics should provide coverage against the most common organisms, including Escherichia coli and Bacteroides fragilis, as well as Klebsiella, Pseudomonas, and Enterococcus species. Sanford Guide recommendations for the treatment of cholecystitis include ampicillin/sulbactam or piperacillin/tazobactam for nonlife-threatening cases of cholecystitis. In life-threatening cases, Sanford recommends imipenem/cilastatin or meropenem. Alternatives include metronidazole plus a third-generation cephalosporin, ciprofloxacin, or aztreonam. […] Meperidine has been shown to provide adequate analgesia without affecting the sphincter of Oddi and, therefore, is the drug of choice. […] This combination is an antipseudomonal penicillin plus a beta-lactamase inhibitor. It inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active multiplication.

• #8 Treatment of acute calculous cholecystitis – UpToDate

  https://www.uptodate.com/contents/treatment-of-acute-calculous-cholecystitis/print

  Treatment of acute calculous cholecystitis […] Cholecystectomy is the mainstay of treatment for ACC. Poor surgical candidates may benefit from initial nonoperative management with antibiotics and a gallbladder drainage procedure; those whose surgical risk improves after resolution of the acute inflammation should undergo elective gallbladder surgery to prevent recurrent symptoms. […] The treatment of ACC will be reviewed here.

• #9 Acute Cholecystitis Treatment & Management: Approach Considerations, Initial Therapy and Antibiotic Treatment, Conservative Treatment of Uncomplicated Cholecystitis

  https://emedicine.medscape.com/article/171886-treatment

  Laparoscopic cholecystectomy is the standard of care for the surgical treatment of acute cholecystitis. […] Studies have indicated that early laparoscopic cholecystectomy resulted in shorter total hospital stays with no significant difference in the conversion rates or complications. […] The American College of Radiology (ACR) criteria state that laparoscopic cholecystectomy is the primary mode of treatment for acute cholecystitis. […] For patients at high surgical risk, placement of a sonographically guided, percutaneous, transhepatic cholecystostomy drainage tube coupled with the administration of antibiotics may provide definitive therapy. […] Endoscopic retrograde cholangiopancreatography (ERCP) allows visualization of the anatomy and can provide therapy by removing stones from the common bile duct. […] Studies indicate that this procedure may be safe as an initial, interim, or definitive treatment of patients with severe acute cholecystitis who are at high operative risk for immediate cholecystectomy.

• #10 Acute cholecystitis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/acute-cholecystitis/

  Surgery can be carried out in two main ways: laparoscopic cholecystectomy a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts (incisions) in your abdomen, and open cholecystectomy where the gallbladder is removed through a single, larger incision in your abdomen. […] In about 1 in every 5 cases of acute cholecystitis, emergency surgery to remove the gallbladder is needed to treat these complications.

• #10 Acute cholecystitis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/acute-cholecystitis/

  If you are diagnosed with acute cholecystitis, you will probably need to be admitted to hospital for treatment. […] Initial treatment will usually involve fasting (not eating or drinking) to take the strain off your gallbladder, receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration, and taking medication to relieve your pain. […] If you have a suspected infection, you will also be given antibiotics. […] In order to prevent acute cholecystitis recurring, and reduce your risk of developing potentially serious complications, the removal of your gallbladder will often be recommended at some point after the initial treatment. […] This type of surgery is known as a cholecystectomy. […] Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you are too unwell to have surgery.

• #11 Cholecystitis (gallbladder inflammation) | healthdirect

  https://www.healthdirect.gov.au/cholecystitis-gallbladder-inflammation

  Cholecystitis needs to be treated in hospital. […] Treatment usually involves: fasting (not eating and drinking), intravenous (IV) fluids fluids given through a drip, antibiotics, pain-relief medicines, surgery to remove your gallbladder. […] Surgery to remove your gallbladder is called a cholecystectomy. This is standard treatment if your cholecystitis is caused by gallstones. […] Your gallbladder may be removed with a procedure called a laparoscopic cholecystectomy. This is a type of keyhole surgery. […] If there are complications during keyhole surgery, your doctors may need to switch to an open operation. […] After the operation, bile will flow straight from your liver to your small intestine. You can live a normal life without your gallbladder.

• #12 Cholecystitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/diagnosis-treatment/drc-20364895

  Procedure to remove stones. You may have a procedure called an endoscopic retrograde cholangiopancreatography (ERCP). This procedure uses dye to make the bile ducts show up during imaging. Then a healthcare professional can use instruments to remove stones blocking the bile ducts or cystic duct. […] Gallbladder drainage. Sometimes, gallbladder drainage, called cholecystostomy, can remove infection. You might have this procedure if you can’t have surgery to remove your gallbladder. […] In time, most people with cholecystitis need surgery to remove the gallbladder. […] The procedure to remove the gallbladder is called a cholecystectomy. Most often, this is a minimally invasive procedure called laparoscopic cholecystectomy. […] If your surgical risk is low, you might have surgery during your hospital stay.

• #13 Chronic cholecystitis: Symptoms, treatment, and more

  https://www.medicalnewstoday.com/articles/chronic-cholecystitis

  The preferred treatment for chronic cholecystitis is laparoscopic cholecystectomy, which involves surgically removing the gallbladder. […] Some doctors may recommend an open cholecystectomy if a laparoscopic procedure is not possible or if there are complications. An open cholecystectomy requires hospital admission and a longer recovery time than a laparoscopic cholecystectomy. […] For people who are not suitable candidates for surgery, nonsurgical options may include: a low fat diet, ursodeoxycholic acid to dissolve gallstones, endoscopic retrograde cholangiopancreatography to remove gallstones, percutaneous cholecystostomy to drain the gallbladder. […] Although nonsurgical treatments can be effective in managing chronic cholecystitis, surgery to remove the gallbladder is often necessary to prevent further complications.

• #14 Chronic Cholecystitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470236/

  Chronic cholecystitis is a prolonged, subacute condition caused by the mechanical or functional dysfunction of the emptying of the gallbladder. […] This activity reviews the pathophysiology of chronic cholecystitis and highlights the role of the interprofessional team in its management. […] Summarize the treatment options for chronic cholecystitis. […] The preferred treatment for chronic cholecystitis is elective laparoscopic cholecystectomy. It has a low morbidity rate and can be performed as an outpatient surgery. An open cholecystectomy is also an option however requires hospital admission and longer recovery time. This surgery is indicated in patients who are not laparoscopic candidates such as those with extensive prior surgeries and adhesions. […] Patients who are not surgical candidates or who prefer not to undergo surgery can be closely observed and managed conservatively. A low-fat diet can help reduce the frequency of symptoms. In patients with symptomatic cholelithiasis, the use of ursodeoxycholic acid (UDCA or ursodiol) has been shown to decrease rates of biliary colic and acute cholecystitis. […] The management of asymptomatic patients with incidentally detected chronic cholecystitis depends on patient characteristics. Asymptomatic patients with no radiological or clinical concerns of malignancy can also be closely monitored with follow-up imaging.

• #15 Management of acute cholecystitis – Primary Care Notebook

  https://primarycarenotebook.com/pages/gastroenterology/management/management-of-acute-cholecystitis

  Percutaneous cholecystostomy: considered in an emergency situation in patients who are not suitable for cholecystectomy because of their general medical condition. […] appropriate treatment in accordance with the severity grade: Grade I (mild) acute cholecystitis: Laparoscopic cholecystectomy (Lap-C) at an early stage within 7 days (within 72 h is better) of onset of symptoms is recommended. […] Grade II (moderate) acute cholecystitis: urgent/early Lap-C if patient performance status is good and advanced Lap-C technique is available. […] Grade III (severe) acute cholecystitis: urgent/early biliary drainage.

• #15 Management of acute cholecystitis – Primary Care Notebook

  https://primarycarenotebook.com/pages/gastroenterology/management/management-of-acute-cholecystitis

  Conservative management:Initially acute cholecystitis is managed conservatively with bed-rest, gut-rest, analgesia with NSAIDs and opiates, anti-emetics, IV fluids and antibiotics: broad-spectrum antibiotics are used to cover the most common organisms found in the biliary tract. […] Surgical management:Cholecystectomy has been the treatment of choice for acute cholecystitis: laparoscopic cholecystectomy is considered the treatment of choice for most patients. […] laparoscopic cholecystectomy within 72 hours of admission is thought to reduce complications and hospital stay. […] urgent cholecystectomy is indicated in the following instances: fever, marked leukocytosis, or diffuse abdominal tenderness indicates possible necrosis, empyema, or rupture and surgery within 12 to 24 hours is indicated.

• #16 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  Acute cholecystitis (AC), generally associated with the presence of gallstones, is a relatively frequent disease that can lead to serious complications. For these reasons, AC warrants prompt clinical diagnosis and management. There is general agreement in terms of considering early laparoscopic cholecystectomy (ELC) to be the best treatment for AC. The optimal timeframe to perform ELC is within 72 h from diagnosis, with a possible extension of up to 7–10 days from symptom onset. […] In patients who are not eligible for ELC, it is suggested to delay surgery at least 6 weeks after the clinical presentation. Critically ill patients, who are unfit for surgery, may require rescue treatments, such as percutaneous or endoscopic gallbladder drainage (GBD). A particular treatment approach should be applied to special populations such as pregnant women, cirrhotic, and elderly patients.

• #17 The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

  https://www.mdpi.com/2077-0383/13/9/2695

  In patients with mild AC but with a concomitant high surgical risk, ELC can be performed once the medical treatment has improved the patient’s general condition. […] GBD, also known as cholecystostomy, should be performed in all patients with severe AC in whom cholecystectomy is contraindicated. Moreover, GBD should also be considered in patients with moderate AC and a high surgical risk, particularly in case of an inadequate response to the medical treatment.

• #18 Acute cholecystitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084

  Acute cholecystitis is a major complication of cholelithiasis (i.e., gallstones); symptomatic gallstones are common before developing cholecystitis. […] Treatment is with antibiotics, analgesia, and fluid resuscitation as required, likely to be followed by an early cholecystectomy.

• #19 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  Although surgery is the treatment of choice for acute cholecystitis, it is associated with increased mortality in older persons. […] In patients who are critically ill with gallbladder empyema and sepsis, cholecystectomy can be life threatening. […] Laparoscopic cholecystectomy is the procedure of choice for those with Child-Pugh class A and B cirrhosis.

• #20 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Oral dissolution therapy using bile acids has successfully dissolved gallstones in an extremely limited patient population. […] Acute cholecystitis develops in up to 10 percent of patients with symptomatic gallstones and is caused by the complete obstruction of the cystic duct. […] Consequently, 12 prospective randomized trials examined whether early cholecystectomy could improve outcomes for acute cholecystitis compared with delayed surgery. […] The current recommendation is for cholecystectomy to be performed during the same hospital admission. […] However, performing cholecystectomy too early in the course of severe gallstone pancreatitis is unwise, and the International Association of Pancreatology recommends waiting for resolution of the pancreatitis and clinical recovery before considering biliary surgery. […] Therefore, it is generally agreed that a more conservative approach is warranted in patients with Child class C cirrhosis and symptomatic gallstone disease, directing treatment toward improving their liver function before cholecystectomy.

• #21 Cholecystitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholecystitis/symptoms-causes/syc-20364867

  Cholecystitis (ko-luh-sis-TIE-tis) is swelling and irritation, called inflammation, of the gallbladder. […] If not treated, cholecystitis can lead to serious complications, such as gallbladder rupture. These can be life-threatening. Treatment for cholecystitis often involves surgery to remove the gallbladder. […] Cholecystitis is when your gallbladder is inflamed. Gallbladder inflammation can be caused by: […] Most often, cholecystitis is the result of hard particles of bile that can form in the gallbladder, called gallstones. […] Cholecystitis that isn’t treated can cause tissue in the gallbladder to die. This is called gangrene. […] A tear, called a perforation, in the gallbladder may result from gallbladder swelling or infection or the death of gallbladder tissue.

• #22 Acute cholecystitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000264.htm

  If you have severe belly pain, seek medical attention right away. […] In the emergency room, you’ll be given fluids through a vein. You also may be given antibiotics to fight infection. […] Cholecystitis may clear up on its own. However, if you have gallstones, you will probably need surgery to remove your gallbladder. […] Nonsurgical treatment includes: Antibiotics you take at home to fight infection, Low-fat diet (if you are able to eat), Pain medicines. […] You may need emergency surgery if you have complications such as: Tissue death (gangrene) of the gallbladder, A hole that forms in the wall of the gallbladder (perforation), Inflamed pancreas (pancreatitis), Persistent bile duct blockage, Inflammation of the common bile duct. […] If you are very ill, a tube may be placed through your belly into your gallbladder to drain it. Once you feel better, your provider may recommend that you have surgery.

• #23

  https://www.nhs.uk/conditions/gallstones/complications/

  Acute cholecystitis is usually first treated with antibiotics to settle the infection and then keyhole surgery to remove the gallbladder. […] Sometimes a severe infection can lead to a gallbladder abscess (empyema of the gallbladder). Antibiotics alone don’t always treat these and they may need to be drained. […] If this happens, you may need antibiotics given directly into a vein (intravenous antibiotics), and surgery may be required to remove a section of the lining if part of it becomes severely damaged. […] Antibiotics will help treat the infection, but it’s also important to help the bile from the liver to drain with an endoscopic retrograde cholangio-pancreatography (ERCP). […] There’s currently no cure for acute pancreatitis, so treatment focuses on supporting the body’s functions until the inflammation has passed.

• #24 Hemorrhagic Cholecystitis | ACS

  https://www.facs.org/for-medical-professionals/news-publications/journals/case-reviews/issues/v2n5/jiang-hemorrhagic/

  A male patient presented with a case of hemorrhagic cholecystitis that, due to delay in diagnosis, resulted in death. […] Our aim is to increase the awareness of this fatal complication of a fairly common disease and review the fundamentals of diagnosis and management of hemorrhagic cholecystitis. […] This case and our literature review illustrate the opportunity for further education about this rare complication of a common pathophysiology. […] Hemorrhagic cholecystitis is a rare complication of this disease process. […] There exist no guidelines for diagnosis or treatment of this disease. […] Our experience with one such case, and our review of the literature, allowed us to attempt to generalize how best to diagnose and manage hemorrhagic cholecystitis. […] Patients with hemodynamic stability can be managed successfully with laparoscopic cholecystectomy.

• #25 Hemorrhagic Cholecystitis | ACS

  https://www.facs.org/for-medical-professionals/news-publications/journals/case-reviews/issues/v2n5/jiang-hemorrhagic/

  However, exploratory laparotomy with open cholecystectomy was required in cases with hemodynamically instability. […] Prompt evaluation and intervention is required for patients with a concerning clinical presentation. […] CT scan is a useful diagnostic tool, and prompt surgical intervention can be lifesaving in patients with hemorrhagic cholecystitis.

• #26 Cholecystitis: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/172067

  After recovering from the condition, it is important to make dietary adjustments that help return bile production to normal. […] A person should eat smaller meals more frequently and avoid large servings or portions, as these can upset the system and produce a gallbladder or bile duct spasm. […] A person should also avoid high fat and fried foods, including whole milk products, and stick to eating lean proteins. […] With appropriate treatment, which is usually a cholecystectomy, most people with cholecystitis will recover and have a good outlook.

• #26 Cholecystitis: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/172067

  Some people with cholecystitis may require hospitalization. They may have to refrain from consuming any solid or liquid foods for some time. Instead, they will receive liquids intravenously, alongside pain medication and antibiotics. […] In many cases, doctors will recommend surgery for acute cholecystitis because there is a high rate of recurrence from inflammation related to gallstones. […] If there is a low risk of complications, the person can have surgery in an outpatient procedure. If a person is already experiencing complications, they will need immediate surgery to remove the gallbladder. […] Surgeons can perform gallbladder removal, called a cholecystectomy, through an open abdominal excision or a laparoscopy. […] Following the surgical removal of the gallbladder, the bile will flow directly into the small intestine from the liver. This does not usually affect the persons overall health and digestive system, but some individuals may have more frequent episodes of diarrhea.

• #27 Cholecystitis (Gallbladder Inflammation): Symptoms, Signs, Treatment, Diet

  https://www.emedicinehealth.com/cholecystitis/article_em.htm

  Is There a Special Diet for Cholecystitis or After a Cholecystectomy? For individuals with cholecystitis, experts suggest a low-fat diet with lean protein sources like fish or poultry. Avoid rapid weight loss and low food intake(less than 800 calories per day) since this can lead to gallstones. After a cholecystectomy, patients should eat smaller and more frequent meals that include: Lean protein sources, Fat-free dairy products, Vegetables, Whole grains, Fruits. […] How Can I Prevent Cholecystitis? You can reduce the risk of getting cholecystitis by slow weight loss, as rapid weight loss increases the risk of developing gallstones. Avoid obesity and a diet high in fat, as a diet high in fiber and low in fat helps to inhibit bile cholesterol from forming gallstones.

• #28 Cholecystitis – what is it, causes, symptoms, diagnosis and treatment in Moscow

  https://www.k31.ru/en/service/gastroenterologiya/cholecystitis.html

  If peritonitis or ascites occurs, surgical treatment of the gallbladder is required. The doctor chooses one of the following methods: […] Cholecystectomy. The standard procedure, the essence of which is to remove the gallbladder. It is performed in the traditional way through a small incision under the ribs or by laparoscopy, which speeds up the recovery process. […] After surgery, the patient should adhere to a therapeutic diet and engage in light physical exercise to stimulate the biliary tract. Walking, yoga, breathing exercises are allowed. […] Patients are advised to undergo regular medical examinations to monitor their condition and detect any possible complications in a timely manner. It is also necessary to take prescribed medications to prevent inflammation and control pain.

• #29 Acute Cholecystitis: Symptoms, Causes, & Treatment – Southlake General Surgery

  https://www.southlakegeneralsurgery.com/acute-cholecystitis-symptoms-causes-treatment/

  In some cases, conservative management may be sufficient to resolve acute cholecystitis without the need for surgery. […] These include open surgery or percutaneous cholecystostomy, a procedure in which a small tube is inserted through the abdominal wall into the gallbladder to drain bile and other fluids, thereby relieving pressure and pain. […] The prognosis for acute cholecystitis is generally good with appropriate treatment. Most patients experience complete remission within 1-4 days, though 25%-30% of patients either develop complications or require emergency surgery. […] Prevention strategies for acute cholecystitis focus on reducing the risk of gallstones through a healthy diet, weight management, and avoiding rapid weight loss. […] With appropriate treatment and lifestyle modifications, most patients can expect a favorable prognosis and a healthier future.

• #30 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00336-x

  The WSES committee for guidelines development is responsible for the continuous evaluation of evidence available about acute cholecystitis. […] Laparoscopic cholecystectomy is generally considered the standard technique for the removal of gallstones. […] A reaffirmation of the safety of laparoscopic cholecystectomy for ACC was shown in another systematic review comparing early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC). […] In summary, the review of the relevant recent literature confirmed strong support for the recommendation that laparoscopic cholecystectomy should be attempted in cases of ACC. […] The timing of laparoscopic cholecystectomy in these patients is controversial. […] Surgery is currently the recommended treatment in people with acute cholecystitis.

• #31 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00336-x

  The pivotal role of surgery is confirmed, including in high-risk patients. […] Early laparoscopic cholecystectomy (ELC) should be the standard of care whenever possible, even in subgroups of patients who are considered fragile, such as the elderly; those with cardiac disease, renal disease and cirrhosis; or those who are generally at high risk for surgery. […] ELC has a central role in the management of patients with ACC. […] The development of local policies for safe laparoscopic cholecystectomy is recommended. […] Cholecystectomy is the most common therapeutic approach for ACC and is considered the standard of care for gallstone disease for the majority of patients. […] The literature review, the discussion of the relevant evidence and the statements made during the consensus conference supported surgery as the gold standard treatment for all patients with ACC, with two exceptions: patients who refuse surgery, and patients for whom surgery would be considered as very high risk.

• #32

  https://journals.lww.com/md-journal/fulltext/2020/02140/long_term_outcomes_of_acute_acalculous.30.aspx

  Although cholecystectomy is generally recommended for acute acalculous cholecystitis (AAC) treatment, non-surgical management can be considered in patients at a high risk for surgery. […] Cholecystectomy is the standard treatment for AAC. Some critical ill patients are unfit for cholecystectomy, and percutaneous cholecystostomy (PC) is performed as a minimally invasive alternative to surgery. […] In the present study, both surgical and non-surgical methods were successful in managing AAC, and overall therapeutic outcomes related to non-surgical group in patients with AAC were not inferior to those in the surgical group. […] In conclusion, recurrence occurred in 9.8% of patients with AAC treated with non-surgical management, and the treatment outcomes of non-surgical group were not inferior to those of the surgical group. Further studies are needed to clarify role of non-surgical management in patients with AAC.

• #33 Conversations in Acute Cholecystitis Management Include Treatment Timing, Robotics | ACS

  https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/september-2024-volume-109-issue-8/conversations-in-acute-cholecystitis-management-include-treatment-timing-robotics/

  Indeed, cholecystectomy is widely considered the ultimate solution for acute calculous cholecystitis. […] Cholecystectomy, especially laparoscopic cholecystectomy, is the gold standard. […] Evidence suggests that early laparoscopic cholecystectomy (within 2 days of cholecystitis episode onset, by most definitions) is the preferred timing, even if the acute disease episode is still taking place. […] Research shows that if you take a gallbladder out during the acute admission you will save the patient a lot of time, you will save the hospital a lot of money, and the patient can return to their work and life faster. […] One of the primary options historically has been percutaneous cholecystostomy (PC) tube placement to drain the gallbladder of bile, which is intended to get the patient past the acute episode of cholecystitis.

• #34 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00336-x

  The recommendation for ELC is strong. […] Immediate laparoscopic cholecystectomy is superior to percutaneous transhepatic gallbladder drainage (PTGBD) in high risk patients with ACC. […] We recommend performing gallbladder drainage in patients with ACC who are not suitable for surgery, as it converts a septic patient with ACC into a non-septic patient.

• #35 Conversations in Acute Cholecystitis Management Include Treatment Timing, Robotics | ACS

  https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/september-2024-volume-109-issue-8/conversations-in-acute-cholecystitis-management-include-treatment-timing-robotics/

  While there is some evidence that PC tubes can act as definitive treatment in select, complicated cases of acute cholecystitis, they are generally considered a bridge to cholecystectomy when possible. […] Subtotal cholecystectomy has been recognized as a critical bailout procedure to avoid bile duct injury while achieving the best-possible surgical outcomes. […] Regardless of which technique is chosen, this alternative to standard laparoscopic cholecystectomy means that a patient may be left feeling that the surgery went wrong which presents an opportunity, if not a mandate, for surgeons to counsel their patients about what this means for their future. […] While laparoscopic cholecystectomy is the current gold standard of treatment for acute cholecystitis, surgeons must continue to be leaders in defining that middle ground so that all patients have access to the safest, most effective treatment available.

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