Does cholecystitis require surgery?

Written by Zhao Xin Lan

Endocrinology

Updated on September 19, 2024

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Whether cholecystitis requires surgery depends on the acute or chronic status of the inflammation and its severity. If it is acute suppurative cholecystitis, emergency surgery is needed to avoid gallbladder perforation and resultant peritonitis, which could lead to serious septic shock, thus emergency surgical treatment is necessary. If it is mild chronic cholecystitis, elective surgery can be considered, and there is no need for emergency treatment. If it is asymptomatic chronic cholecystitis, it can also be managed with dietary adjustments and symptomatic medical treatment, and surgery may not be strictly necessary.

Other Voices

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Written by Liu Wu Cai

Hepatobiliary Surgery

1min

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Does acute cholecystitis fear cold?

Patients with acute cholecystitis may exhibit chills. Due to the acute inflammation of the gallbladder in patients with acute cholecystitis, symptoms such as chills, high fever, fatigue, and loss of appetite which are characteristic of systemic infections may occur. Additionally, patients may experience significant pain in the upper right abdomen, which tends to worsen after eating. In cases of acute cholecystitis, it is crucial to use antibiotics for anti-infection treatment as soon as possible. Only when the inflammation is controlled can the condition be alleviated. In cases where gallstones cause cholecystitis, surgical treatment should be employed promptly. A complete cure can only be achieved by surgically removing the gallbladder. Therefore, it is essential to take acute cholecystitis seriously and seek medical attention promptly to actively manage the condition and significantly improve the patient's prognosis.

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Written by Huang Ya Juan

Gastroenterology

3min 8sec

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Symptoms and Treatment of Cholecystitis

Cholecystitis is divided into acute cholecystitis and chronic cholecystitis. Acute cholecystitis typically presents very typical and obvious clinical symptoms, primarily manifesting as acute abdominal pain. Acute cholecystitis often occurs after eating greasy food, mainly presenting as severe colicky pain in the upper right abdomen, which is episodic and worsens. The pain may radiate to the right shoulder or back, followed by nausea, vomiting, and in severe cases, fever. Some severe cases may also present with jaundice and symptoms of systemic infection and toxicity. Acute simple cholecystitis is often treated non-surgically, and most cases can be cured. If the patient has a history of multiple attacks or the presence of stones, elective cholecystectomy is usually performed later. For suppurative or gangrenous cholecystitis, surgery should be performed promptly after appropriate preparation to remove the diseased gallbladder, typically within three days of onset. If the patient's condition is critical at the time of surgery, or if there is severe local infection and the anatomy is unclear, the doctor will not forcibly remove the gallbladder to avoid major bleeding and damage. Instead, a cholecystostomy may be performed first, followed by cholecystectomy after three months. Chronic cholecystitis, besides occasional upper abdominal discomfort and indigestion, usually shows no prominent symptoms, and most patients only learn about their condition through ultrasound examination. However, for recurrent acute attacks or symptomatic chronic cholecystitis, especially those with stones larger than 1 cm or multiple stones, cholecystectomy should be performed. Elderly or frail individuals with other serious illnesses, such as cardiovascular disease, diabetes, kidney disease, or liver disease, may receive medical treatment, including general digestive aids and antispasmodic medications. Bile preparations have choleretic effects, can increase the secretion of bile, promote the digestion and absorption of fats, and facilitate the excretion from the gallbladder, which can alleviate symptoms and stabilize the condition. Considering that acute attacks of chronic cholecystitis in elderly people progress rapidly and that emergency surgery has a much higher mortality rate than elective surgery, it is advisable to perform surgery during a remission period. Whether treated with medication or surgery, it is important to follow medical advice.

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Written by Zhang Jun Jun

Endocrinology

1min 2sec

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How to Diagnose Cholecystitis

The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.

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Written by Wu Hai Wu

Gastroenterology

40sec

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What should I do if cholecystitis does not improve?

If cholecystitis does not improve over time, it is crucial to actively identify the reasons behind this persistent issue. For instance, it could be due to improper diet, such as frequently consuming greasy foods or overeating. It might also be due to an acute exacerbation of chronic cholecystitis, or possibly because of the presence of polyps or stones in the gallbladder, which can lead to persistent cholecystitis. In such cases, it is important to pay closer attention to the diet, opting for lighter meals, and to take oral anti-inflammatory and bile-promoting medications for treatment. If necessary, gallbladder removal surgery may be required.

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Written by Wu Hai Wu

Gastroenterology

44sec

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What are the symptoms when there are problems with the gallbladder?

Gallbladder issues, specifically symptoms of cholecystitis, mainly include chills, fever, persistent dull pain in the upper right quadrant of the abdomen, episodic colic pain that radiates to the right shoulder and back, and may also be accompanied by jaundice, dark urine, nausea, vomiting, and constipation. Patients with cholecystitis often experience sudden pain at night, typically due to overeating or consuming greasy foods. Once cholecystitis occurs, it is advised to seek medical attention at a regular hospital as soon as possible, complete the relevant diagnostic tests, such as imaging studies of the abdomen, consider surgical treatment, and engage in active anti-infection treatment.