Acute Cholecystitis
Topic overview
Two general surgery faculty discuss the clinical management of acute cholecystitis, covering diagnostic approaches, treatment strategies, and surgical decision-making. This educational discussion provides practical insights into gallbladder disease management for surgeons and trainees.
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Key takeaways
- Acute cholecystitis requires prompt diagnosis via ultrasound showing gallbladder wall thickening, pericholecystic fluid, and Murphy's sign
- Early cholecystectomy (within 72 hours) reduces complications compared to delayed surgery in acute cholecystitis
- Laparoscopic approach is preferred for acute cholecystitis when feasible, with conversion to open if anatomy unclear
- Antibiotics alone are temporizing; definitive treatment is cholecystectomy to prevent recurrence and complications
- High-risk patients may require percutaneous cholecystostomy as bridge to definitive surgery or for palliation
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