Acute Cholecystitis: Management
Treatment of cholecystitis depends on the severity of the condition and the presence or absence of complications.
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EtiologyPathophysiologyHistoryPhysical ExaminationInvestigationsDifferential DiagnosisManagementClinical ScenariosAnswers |
Laparoscopic cholecystectomy is the
standard of care for the surgical treatment of cholecystitis. Studies have
indicated that early laparoscopic cholecystectomy resulted in shorter total
hospital stays with no significant difference in conversion rates or
complications.
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) issued guidelines for the clinical application of laparoscopic biliary tract surgery in 2010. The guidelines include detailed recommendations for making the decision to operate, performing the procedure, and managing postoperative care, with the patient's safety always the primary consideration. Recommendations are as follows:
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) issued guidelines for the clinical application of laparoscopic biliary tract surgery in 2010. The guidelines include detailed recommendations for making the decision to operate, performing the procedure, and managing postoperative care, with the patient's safety always the primary consideration. Recommendations are as follows:
- Preoperative antibiotics should be considered only to reduce the possibility of wound infection in high-risk patients, and then limited to one preoperative dose.
- Intraoperative cholangiography may improve injury recognition and decrease the risk of bile duct injury.
- If bile duct injury occurs, the patient should be referred to an experienced hepatobiliary specialist before any repair is undertaken, unless the primary surgeon has experience with biliary reconstruction.