Acute Cholecystitis
Sudden inflammation of the gallbladder, usually caused by a gallstone blocking the cystic duct.
Overview
Acute cholecystitis is inflammation of the gallbladder, usually caused by gallstones blocking the cystic duct. It's one of the most common surgical emergencies. Early laparoscopic cholecystectomy (within 72 hours) is the standard of care and provides better outcomes than delayed surgery.
Causes
- Gallstones impacting the cystic duct (90-95% of cases)
- Acalculous cholecystitis (in critically ill/ICU patients)
- Biliary sludge
- Gallbladder ischemia
Risk Factors
- Gallstones (most significant risk)
- Female gender
- Age over 40
- Obesity
- Rapid weight loss
- Pregnancy
- Total parenteral nutrition
Symptoms
Diagnosis
- Ultrasound abdomen (gallstones + thickened wall + pericholecystic fluid)
- Blood tests (elevated WBC, CRP)
- HIDA scan (if ultrasound inconclusive)
- CT scan (for complications: perforation, abscess)
Treatment Options
Surgical Treatment
Early laparoscopic cholecystectomy (within 72 hours of symptom onset) is the gold standard. Dr. Bhagat performs this routinely with same-day or next-day discharge for uncomplicated cases. For gangrenous or perforated gallbladder, subtotal cholecystectomy or conversion to open may be needed.
Recovery
Laparoscopic cholecystectomy: Most patients go home within 24 hours. Return to desk work in 3-5 days. Full activities in 1-2 weeks. Open surgery: 3-5 days hospital stay, 4-6 weeks full recovery.
Prevention
- Maintain healthy weight
- Avoid crash diets
- High-fiber, low-fat diet
- Regular exercise
- Consider cholecystectomy for symptomatic gallstones before they cause acute cholecystitis
Frequently Asked Questions
Is cholecystitis an emergency?
Can I live without a gallbladder?
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