Acute Cholecystitis
Topic overview
Two general surgery faculty engage in an interactive discussion covering the clinical presentation, diagnosis, and surgical management of acute cholecystitis. This educational dialogue provides practical insights into gallbladder disease management for surgical trainees and practicing surgeons.
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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 after initial medical management
- Laparoscopic approach is preferred when feasible, but conversion to open may be necessary in severe inflammation or unclear anatomy
- Antibiotic coverage should target gram-negative and anaerobic organisms; typical regimens include cephalosporins plus metronidazole
- High-risk surgical candidates may benefit from percutaneous cholecystostomy as a temporizing or definitive measure
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