Skip to main content
SpringerLink
Log in

Surgical management of acute cholecystitis

  • Review Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

Acute cholecystitis occurs in approximately 1 % of patients with known gallstones. It presents as a surgical emergency and usually requires hospitalisation for treatment. It is associated with significant morbidity and mortality, particularly in the elderly. Cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of debate. This review examines the available evidence regarding the optimal surgical management of patients with acute cholecystitis.

Methods

A literature search was performed on the MEDLINE, EMBASE and WHO International Clinical Trials Registry Platform, databases for English language publications. The MeSH headings ‘cholecystitis’, ‘acute’, ‘gallbladder’, ‘inflammation’, ‘surgery’, ‘cholecystectomy’, ‘laparoscopic’, ‘robotic’, ‘telerobotic’ and ‘computer-assisted’ were used.

Results

Data from eight randomised controlled trails and three population-based analyses show that early cholecystectomy for acute cholecystitis performed on the index admission is safe and not associated with increased conversion rates or morbidity in comparison to conservative treatment followed by elective cholecystectomy. Delaying cholecystectomy increases readmissions for gallstone-related events, complications, hospital stay and mortality in the elderly. Early cholecystectomy is also more cost-effective. Randomised trials addressing antibiotic use in acute cholecystitis suggest that antibiotics should be stopped on the day of cholecystectomy. Insufficient trials have been performed to address the optimal analgesia regime post cholecystectomy. Similarly, a lack of trials on intraoperative cholangiography and management of common bile duct stones in patients with acute cholecystitis means that treatment of concomitant bile duct stones should be based on institutional expertise and resource availability. As regards acute cholecystitis in elderly and high-risk patients, case series and retrospective studies would suggest that cholecystectomy is more effective and of lower mortality than percutaneous cholecystostomy. There is not enough evidence to support the routine use of robotic surgery, single-incision laparoscopic cholecystectomy or natural orifice transluminal endoscopic surgery (NOTES) in the treatment of acute cholecystitis.

Conclusions

Trial evidence would favour a policy of early laparoscopic cholecystectomy following admission with acute cholecystitis. The optimal approach to support early cholecystectomy is suggested but requires evidence from further randomised trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Stinton LM, Shaffer EA (2012) Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 6(2):172–187. doi:10.5009/gnl.2012.6.2.172

    Article  PubMed Central  PubMed  Google Scholar 

  2. Glasgow RE, Cho M, Hutter MM, Mulvihill SJ (2000) The spectrum and cost of complicated gallstone disease in California. Arch Surg (Chicago, Ill: 1960) 135(9):1021–1025, discussion 1025–1027

    Article  CAS  Google Scholar 

  3. Sanders G, Kingsnorth AN (2007) Gallstones. BMJ (Clin Res ed) 335(7614):295–299. doi:10.1136/bmj.39267.452257.AD

    Article  Google Scholar 

  4. Williams JG, Roberts SE, Ali MF, Cheung WY, Cohen DR, Demery G, Edwards A, Greer M, Hellier MD, Hutchings HA, Ip B, Longo MF, Russell IT, Snooks HA, Williams JC (2007) Gastroenterology services in the UK. The burden of disease, and the organisation and delivery of services for gastrointestinal and liver disorders: a review of the evidence. Gut 56(Suppl 1):1–113. doi:10.1136/gut.2006.117598

    Article  PubMed  Google Scholar 

  5. Primary diagnosis: 3 character. (2011–2012) HESonline. http://www.hesonline.nhs.uk/. Accessed 1 January 2015

  6. Myer PA, Mannalithara A, Singh G, Singh G, Pasricha PJ, Ladabaum U (2013) Clinical and economic burden of emergency department visits due to gastrointestinal diseases in the United States. Am J Gastroenterol 108(9):1496–1507. doi:10.1038/ajg.2013.199

    Article  PubMed  Google Scholar 

  7. Parker LJ, Vukov LF, Wollan PC (1997) Emergency department evaluation of geriatric patients with acute cholecystitis. Acad Emerg Med:Off J Soc Acad Emerg Med 4(1):51–55

    Article  CAS  Google Scholar 

  8. Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR (2010) Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 97(2):141–150. doi:10.1002/bjs.6870

    Article  CAS  PubMed  Google Scholar 

  9. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. The Cochrane database of systematic reviews (4):Cd006231. doi:10.1002/14651858.cd006231

  10. David GG, Al-Sarira AA, Willmott S, Deakin M, Corless DJ, Slavin JP (2008) Management of acute gallbladder disease in England. Br J Surg 95(4):472–476. doi:10.1002/bjs.5984

    Article  CAS  PubMed  Google Scholar 

  11. Senapati PSP, Bhattarcharya D, Harinath G, Ammori BJ (2003) A survey of the timing and approach to the surgical management of cholelithiasis in patients with acute biliary pancreatitis and acute cholecystitis in the UK. Ann R Coll Surg Engl 85(5):306–312. doi:10.1308/003588403769162404

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Lo CM, Liu CL, Fan ST, Lai EC, Wong J (1998) Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 227(4):461–467

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, Lau WY (1998) Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 85(6):764–767. doi:10.1046/j.1365-2168.1998.00708.x

    Article  CAS  PubMed  Google Scholar 

  14. Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L (2003) Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg 7(5):642–645. doi:10.1016/S1091-255X(03)00065-9

    Article  PubMed  Google Scholar 

  15. Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, Seenu V (2004) Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc 18(9):1323–1327. doi:10.1007/s00464-003-9230-6

    Article  CAS  PubMed  Google Scholar 

  16. Ozkardes AB, Tokac M, Dumlu EG, Bozkurt B, Ciftci AB, Yetisir F, Kilic M (2014) Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study. Int Surg 99(1):56–61. doi:10.9738/intsurg-d-13-00068.1

    Article  PubMed Central  PubMed  Google Scholar 

  17. Gul R, Dar RA, Sheikh RA, Salroo NA, Matoo AR, Wani SH (2013) Comparison of early and delayed laparoscopic cholecystectomy for acute cholecystitis: experience from a single center. N Am J Med Sci 5(7):414–418. doi:10.4103/1947-2714.115783

    Article  PubMed Central  PubMed  Google Scholar 

  18. Yadav RP, Adhikary S, Agrawal CS, Bhattarai B, Gupta RK, Ghimire A (2009) A comparative study of early vs. delayed laparoscopic cholecystectomy in acute cholecystitis. Kathmandu Univ Med J (KUMJ) 7(25):16–20

    CAS  Google Scholar 

  19. Gutt CN, Encke J, Koninger J, Harnoss JC, Weigand K, Kipfmuller K, Schunter O, Gotze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K, Ackmann S, Baron A, Schon MR, Seitz HK, Daniel D, Stremmel W, Buchler MW (2013) Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg 258(3):385–393. doi:10.1097/SLA.0b013e3182a1599b

    Article  PubMed  Google Scholar 

  20. Macafee DA, Humes DJ, Bouliotis G, Beckingham IJ, Whynes DK, Lobo DN (2009) Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease. Br J Surg 96(9):1031–1040. doi:10.1002/bjs.6685

    Article  CAS  PubMed  Google Scholar 

  21. Wilson E, Gurusamy K, Gluud C, Davidson BR (2010) Cost-utility and value-of-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 97(2):210–219. doi:10.1002/bjs.6872

    Article  CAS  PubMed  Google Scholar 

  22. Johner A, Raymakers A, Wiseman SM (2013) Cost utility of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Surg Endosc 27(1):256–262. doi:10.1007/s00464-012-2430-1

    Article  PubMed  Google Scholar 

  23. de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Nathens AB (2013) A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy. J Trauma Acute Care Surg 74(1):26–30. doi:10.1097/TA.0b013e3182788e4d, discussion 30–21

    Article  PubMed  Google Scholar 

  24. Riall TS, Zhang D, Townsend CM Jr, Kuo YF, Goodwin JS (2010) Failure to perform cholecystectomy for acute cholecystitis in elderly patients is associated with increased morbidity, mortality, and cost. J Am Coll Surg 210(5):668–677. doi:10.1016/j.jamcollsurg.2009.12.031, 677–669

    Article  PubMed Central  PubMed  Google Scholar 

  25. de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Alali AS, Nathens AB (2014) Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis. Ann Surg 259(1):10–15. doi:10.1097/SLA.0b013e3182a5cf36

    Article  PubMed  Google Scholar 

  26. Banz V, Gsponer T, Candinas D, Guller U (2011) Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy. Ann Surg 254(6):964–970. doi:10.1097/SLA.0b013e318228d31c

    Article  PubMed  Google Scholar 

  27. Mazeh H, Mizrahi I, Dior U, Simanovsky N, Shapiro M, Freund HR, Eid A (2012) Role of antibiotic therapy in mild acute calculus cholecystitis: a prospective randomized controlled trial. World J Surg 36(8):1750–1759. doi:10.1007/s00268-012-1572-6

    Article  PubMed  Google Scholar 

  28. Regimbeau JM, Fuks D, Pautrat K, Mauvais F, Haccart V, Msika S, Mathonnet M, Scotte M, Paquet JC, Vons C, Sielezneff I, Millat B, Chiche L, Dupont H, Duhaut P, Cosse C, Diouf M, Pocard M (2014) Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial. JAMA 312(2):145–154. doi:10.1001/jama.2014.7586

    Article  PubMed  Google Scholar 

  29. Ito K, Fujita N, Noda Y, Kobayashi G, Kimura K, Sugawara T, Horaguchi J (2004) Percutaneous cholecystostomy versus gallbladder aspiration for acute cholecystitis: a prospective randomized controlled trial. AJR Am J Roentgenol 183(1):193–196. doi:10.2214/ajr.183.1.1830193

    Article  PubMed  Google Scholar 

  30. Hunt DR, Chu FC (2000) Gangrenous cholecystitis in the laparoscopic era. Aust N Z J Surg 70(6):428–430

    Article  CAS  PubMed  Google Scholar 

  31. Watanabe Y, Nagayama M, Okumura A, Amoh Y, Katsube T, Suga T, Koyama S, Nakatani K, Dodo Y (2007) MR imaging of acute biliary disorders. Radiographics 27(2):477–495

    Article  PubMed  Google Scholar 

  32. Bennett GL, Rusinek H, Lisi V, Israel GM, Krinsky GA, Slywotzky CM, Megibow A (2002) CT findings in acute gangrenous cholecystitis. AJR Am J Roentgenol 178(2):275–281. doi:10.2214/ajr.178.2.1780275

    Article  PubMed  Google Scholar 

  33. Fagan SP, Awad SS, Rahwan K, Hira K, Aoki N, Itani KM, Berger DH (2003) Prognostic factors for the development of gangrenous cholecystitis. Am J Surg 186(5):481–485

    Article  PubMed  Google Scholar 

  34. McArthur P, Cuschieri A, Sells RA, Shields R (1975) Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis. Br J Surg 62(10):850–852

    Article  CAS  PubMed  Google Scholar 

  35. Jones PF (1982) Acute cholecystitis: a case for early surgery? Br Med J (Clin Res Ed) 285(6352):1376–1377

    Article  CAS  Google Scholar 

  36. Lee AY, Carter JJ, Hochberg MS, Stone AM, Cohen SL, Pachter HL (2008) The timing of surgery for cholecystitis: a review of 202 consecutive patients at a large municipal hospital. Am J Surg 195(4):467–470. doi:10.1016/j.amjsurg.2007.04.015

    Article  PubMed  Google Scholar 

  37. Vetrhus M, Soreide O, Nesvik I, Sondenaa K (2003) Acute cholecystitis: delayed surgery or observation. A randomized clinical trial. Scand J Gastroenterol 38(9):985–990

    Article  CAS  PubMed  Google Scholar 

  38. Schmidt M, Sondenaa K, Vetrhus M, Berhane T, Eide GE (2011) Long-term follow-up of a randomized controlled trial of observation versus surgery for acute cholecystitis: non-operative management is an option in some patients. Scand J Gastroenterol 46(10):1257–1262. doi:10.3109/00365521.2011.598548

    Article  PubMed  Google Scholar 

  39. Stevens KA, Chi A, Lucas LC, Porter JM, Williams MD (2006) Immediate laparoscopic cholecystectomy for acute cholecystitis: no need to wait. Am J Surg 192(6):756–761. doi:10.1016/j.amjsurg.2006.08.040

    Article  PubMed  Google Scholar 

  40. Degrate L, Ciravegna AL, Luperto M, Guaglio M, Garancini M, Maternini M, Giordano L, Romano F, Gianotti L, Uggeri F (2013) Acute cholecystitis: the golden 72-h period is not a strict limit to perform early cholecystectomy. Results from 316 consecutive patients. Langenbeck’s Arch Surg Deut Ges Chir 398(8):1129–1136. doi:10.1007/s00423-013-1131-0

    Article  Google Scholar 

  41. Ohta M, Iwashita Y, Yada K, Ogawa T, Kai S, Ishio T, Shibata K, Matsumoto T, Bandoh T, Kitano S (2012) Operative timing of laparoscopic cholecystectomy for acute cholecystitis in a Japanese institute. JSLS: J Soc Laparoendosc Surg / Soc Laparoendosc Surg 16(1):65–70. doi:10.4293/108680812x13291597716023

    Article  Google Scholar 

  42. Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, Buchler MW, Gomi H, Dervenis C, Windsor JA, Kim SW, de Santibanes E, Padbury R, Chen XP, Chan AC, Fan ST, Jagannath P, Mayumi T, Yoshida M, Miura F, Tsuyuguchi T, Itoi T, Supe AN (2013) TG13 surgical management of acute cholecystitis. J Hepato-Biliary-Pancreat Sci 20(1):89–96. doi:10.1007/s00534-012-0567-x

    Article  Google Scholar 

  43. Campanile FC, Pisano M, Coccolini F, Catena F, Agresta F, Ansaloni L (2014) Acute cholecystitis: WSES position statement. World J Emerg Surg: WJES 9(1):58. doi:10.1186/1749-7922-9-58

    Article  PubMed Central  PubMed  Google Scholar 

  44. Wu JX, Nguyen AT, de Virgilio C, Plurad DS, Kaji AH, Nguyen BSV, Gifford E, de Virgilio M, Ayabe MDR, Saltzman D, Kim D (2014) Can it wait until morning? A comparison of nighttime versus daytime cholecystectomy for acute cholecystitis. Am J Surg 208(6):911–918. doi:10.1016/j.amjsurg.2014.09.004

    Article  PubMed  Google Scholar 

  45. Abelson JS, Afaneh C, Rich BS, Dakin G, Zarnegar R, Fahey TJ, Pomp A 3rd (2014) Advanced laparoscopic fellowship training decreases conversion rates during laparoscopic cholecystectomy for acute biliary diseases: a retrospective cohort study. Int J Surg (London, England) 13c:221–226. doi:10.1016/j.ijsu.2014.12.016

    Google Scholar 

  46. Low JK, Barrow P, Owera A, Ammori BJ (2007) Timing of laparoscopic cholecystectomy for acute cholecystitis: evidence to support a proposal for an early interval surgery. Am Surg 73(11):1188–1192

    PubMed  Google Scholar 

  47. Zhu B, Zhang Z, Wang Y, Gong K, Lu Y, Zhang N (2012) Comparison of laparoscopic cholecystectomy for acute cholecystitis within and beyond 72 h of symptom onset during emergency admissions. World J Surg 36(11):2654–2658. doi:10.1007/s00268-012-1709-7

    Article  PubMed  Google Scholar 

  48. Farooq T, Buchanan G, Manda V, Kennedy R, Ockrim J (2009) Is early laparoscopic cholecystectomy safe after the “safe period”? J Laparoendosc Adv Surg Tech Part A 19(4):471–474. doi:10.1089/lap.2008.0363

    Article  Google Scholar 

  49. Hadad SM, Vaidya JS, Baker L, Koh HC, Heron TP, Hussain K, Thompson AM (2007) Delay from symptom onset increases the conversion rate in laparoscopic cholecystectomy for acute cholecystitis. World J Surg 31(6):1298–1201. doi:10.1007/s00268-007-9050-2, discussion 1302–1293

    Article  PubMed  Google Scholar 

  50. Overby DW, Apelgren KN, Richardson W, Fanelli R (2010) SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc 24(10):2368–2386. doi:10.1007/s00464-010-1268-7

    Article  PubMed  Google Scholar 

  51. Strasberg SM, Hertl M, Soper NJ (1995) An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 180(1):101–125

    CAS  PubMed  Google Scholar 

  52. Dolan JP, Diggs BS, Sheppard BC, Hunter JG (2009) The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997–2006. J Gastrointest Surg 13(12):2292–2301. doi:10.1007/s11605-009-0988-2

    Article  PubMed  Google Scholar 

  53. Williams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M (2008) Guidelines on the management of common bile duct stones (CBDS). Gut 57(7):1004–1021. doi:10.1136/gut.2007.121657

    Article  CAS  PubMed  Google Scholar 

  54. Norrby S, Heuman R, Sjodahl R (1985) Acute cholecystitis. Frequency of stones in the common duct and predictive value of liver function tests. Ann Chir Gynaecol 74(1):9–12

    CAS  PubMed  Google Scholar 

  55. Videhult P, Sandblom G, Rudberg C, Rasmussen IC (2011) Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones? Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy. HPB: Off J Int Hepato Pancreato Biliary Assoc 13(8):519–527. doi:10.1111/j.1477-2574.2011.00317.x

    Article  Google Scholar 

  56. Ford JA, Soop M, Du J, Rodgers M, Loveday BPT (2012) Systematic review of intraoperative cholangiography in cholecystectomy. Br J Surg 99(2):160–167

    Article  CAS  PubMed  Google Scholar 

  57. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O’Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG (2010) Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis: Off Publ Infect Dis Soc Am 50(2):133–164. doi:10.1086/649554

    Article  Google Scholar 

  58. Gomi H, Solomkin JS, Takada T, Strasberg SM, Pitt HA, Yoshida M, Kusachi S, Mayumi T, Miura F, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Windsor JA, Dervenis C, Liau KH, Kim MH (2013) TG13 antimicrobial therapy for acute cholangitis and cholecystitis. J Hepato-Biliary-Pancreat Sci 20(1):60–70. doi:10.1007/s00534-012-0572-0

    Article  Google Scholar 

  59. Rodriguez-Sanjuan JC, Casella G, Antolin F, Castillo F, Fernandez-Santiago R, Riano M, Herrera LA, Gomez-Fleitas M (2013) How long is antibiotic therapy necessary after urgent cholecystectomy for acute cholecystitis? J Gastrointest Surg 17(11):1947–1952. doi:10.1007/s11605-013-2321-3

    Article  PubMed  Google Scholar 

  60. Badia-Perez JJ, Aldeano A, Oms L, Guirao X, Nve E, Roson N (2011) Randomised trial of a short course of postoperative antibiotic therapy in low-risk acute cholecystitis. Surg Infect 12(2):A2–A3

    Google Scholar 

  61. Lau WY, Yuen WK, Chu KW, Chong KK, Li AK (1990) Systemic antibiotic regimens for acute cholecystitis treated by early cholecystectomy. Aust N Z J Surg 60(7):539–543

    Article  CAS  PubMed  Google Scholar 

  62. Roberts KJ, Gilmour J, Pande R, Hodson J, Lam FT, Khan S (2013) Double-blind randomized sham controlled trial of intraperitoneal bupivacaine during emergency laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int: HBPD INT 12(3):310–316

    Article  PubMed  Google Scholar 

  63. Gurusamy KS, Vaughan J, Toon CD, Davidson BR (2014) Pharmacological interventions for prevention or treatment of postoperative pain in people undergoing laparoscopic cholecystectomy. Cochrane Database Syst Rev 3:Cd008261. doi:10.1002/14651858.CD008261.pub2

    PubMed  Google Scholar 

  64. Gurusamy KS, Nagendran M, Guerrini GP, Toon CD, Zinnuroglu M, Davidson BR (2014) Intraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy. Cochrane Database Syst Rev 3:Cd007337. doi:10.1002/14651858.CD007337.pub3

    PubMed  Google Scholar 

  65. Loizides S, Gurusamy KS, Nagendran M, Rossi M, Guerrini GP, Davidson BR (2014) Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy. Cochrane Database Syst Rev 3:Cd007049. doi:10.1002/14651858.CD007049.pub2

    PubMed  Google Scholar 

  66. Venara A, Carretier V, Lebigot J, Lermite E (2014) Technique and indications of percutaneous cholecystostomy in the management of cholecystitis in 2014. J Visceral Surg 151(6):435–439. doi:10.1016/j.jviscsurg.2014.06.003

    Article  CAS  Google Scholar 

  67. Akyurek N, Yuksel O, Irkorucu O, Akyürek N, Salman B, Yüksel O, Tezcaner T, Irkörücü O, Yücel C, Oktar S (2005) Management of acute calculous cholecystitis in high-risk patients: percutaneous cholecystotomy followed by early laparoscopic cholecystectomy. Surg Laparosc Endosc Percutaneous Tech 15(6):315–320

    Article  Google Scholar 

  68. Hatzidakis A, Prassopoulos P, Petinarakis I, Sanidas E, Chrysos E, Chalkiadakis G, Tsiftsis D, Gourtsoyiannis N (2002) Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment. Eur Radiol 12(7):1778–1784

    Article  PubMed  Google Scholar 

  69. Winbladh A, Gullstrand P, Svanvik J, Sandstrom P (2009) Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB: Off J Int Hepato Pancreato Biliary Assoc 11(3):183–193. doi:10.1111/j.1477-2574.2009.00052.x

    Article  Google Scholar 

  70. Saad WE, Wallace MJ, Wojak JC, Kundu S, Cardella JF (2010) Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Int Radiol: JVIR 21(6):789–795. doi:10.1016/j.jvir.2010.01.012

    Article  Google Scholar 

  71. Mutignani M, Iacopini F, Perri V, Familiari P, Tringali A, Spada C, Ingrosso M, Costamagna G (2009) Endoscopic gallbladder drainage for acute cholecystitis: technical and clinical results. Endoscopy 41(6):539–546. doi:10.1055/s-0029-1214727

    Article  CAS  PubMed  Google Scholar 

  72. Rodriguez-Sanjuan JC, Arruabarrena A, Sanchez-Moreno L, Gonzalez-Sanchez F, Herrera LA, Gomez-Fleitas M (2012) Acute cholecystitis in high surgical risk patients: percutaneous cholecystostomy or emergency cholecystectomy? Am J Surg 204(1):54–59. doi:10.1016/j.amjsurg.2011.05.013

    Article  PubMed  Google Scholar 

  73. Gunay Y, Bircan HY, Emek E, Cevik H, Altaca G, Moray G (2013) The management of acute cholecystitis in chronic hemodialysis patients: percutaneous cholecystostomy versus cholecystectomy. J Gastrointest Surg 17(2):319–325. doi:10.1007/s11605-012-2067-3

    Article  PubMed  Google Scholar 

  74. Kortram K, van Ramshorst B, Bollen TL, Besselink MG, Gouma DJ, Karsten T, Kruyt PM, Nieuwenhuijzen GA, Kelder JC, Tromp E, Boerma D (2012) Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): study protocol for a randomized controlled trial. Trials 13:7. doi:10.1186/1745-6215-13-7

    Article  PubMed Central  PubMed  Google Scholar 

  75. Veerappan A, Gawron A, Soper N, Keswani R (2013) Delaying cholecystectomy for complicated gallstone disease in pregnancy is associated with recurrent postpartum symptoms. J Gastrointest Surg 17(11):1953–1959

    Article  PubMed  Google Scholar 

  76. Dietrich CS 3rd, Hill CC, Hueman M (2008) Surgical diseases presenting in pregnancy. Surg Clin N Am 88(2):403–419. doi:10.1016/j.suc.2007.12.003, vii-viii

    Article  PubMed  Google Scholar 

  77. Gilo NB, Amini D, Landy HJ (2009) Appendicitis and cholecystitis in pregnancy. Clin Obstet Gynecol 52(4):586–596. doi:10.1097/GRF.0b013e3181c11d10

    Article  PubMed  Google Scholar 

  78. Sucandy I, Tellagorry J, Kolff JW (2013) Minimally invasive surgical management of acute cholecystitis during pregnancy: what are the recommendations? Am Surg 79(7):E251–E252

    PubMed  Google Scholar 

  79. Pearl J, Price R, Richardson W, Fanelli R (2011) Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Surg Endosc 25(11):3479–3492. doi:10.1007/s00464-011-1927-3

    Article  PubMed  Google Scholar 

  80. Ferreres AR, Asbun HJ (2014) Technical aspects of cholecystectomy. Surg Clin N Am 94(2):427–454. doi:10.1016/j.suc.2014.01.007

    Article  PubMed  Google Scholar 

  81. Pearl JP, Ponsky JL (2008) Natural orifice translumenal endoscopic surgery: a critical review. J Gastrointest Surg 12(7):1293–1300. doi:10.1007/s11605-007-0424-4

    Article  PubMed  Google Scholar 

  82. Noguera JF, Cuadrado A, Sanchez-Margallo FM, Dolz C, Asencio JM, Olea JM, Morales R, Lozano L, Vicens JC (2011) Emergency transvaginal hybrid natural orifice transluminal endoscopic surgery. Endoscopy 43(5):442–444. doi:10.1055/s-0030-1256042

    Article  CAS  PubMed  Google Scholar 

  83. Kim MJ, Kim TS, Kim KH, An CH, Kim JS (2014) Safety and feasibility of needlescopic grasper-assisted single-incision laparoscopic cholecystectomy in patients with acute cholecystitis: comparison with three-port laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech Part A 24(8):523–527. doi:10.1089/lap.2013.0552

    Article  Google Scholar 

  84. Ayloo S, Roh Y, Choudhury N (2014) Laparoscopic versus robot-assisted cholecystectomy: a retrospective cohort study. Int J Surg (London, England) 12(10):1077–1081. doi:10.1016/j.ijsu.2014.08.405

    Article  Google Scholar 

  85. Cameron I, Chadwick C, Phillips J, Johnson A (2004) Management of acute cholecystitis in UK hospitals: time for a change. Postgrad Med J 80(943):292–294. doi:10.1136/pgmj.2002.004085

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  86. Agrawal S, Battula N, Barraclough L, Durkin D, Cheruvu CV (2009) Early laparoscopic cholecystectomy service provision is feasible and safe in the current UK National Health Service. Ann R Coll Surg Engl 91(8):660–664. doi:10.1308/003588409x464478

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  87. Mercer SJ, Knight JS, Toh SK, Walters AM, Sadek SA, Somers SS (2004) Implementation of a specialist-led service for the management of acute gallstone disease. Br J Surg 91(4):504–508. doi:10.1002/bjs.4458

    Article  CAS  PubMed  Google Scholar 

  88. Pilkington ST, Toh SK, Walters AM, Sadek SA, Somers SS (2006) Specialist-led service for the management of acute gallstone disease—the first three years (abstract). Br J Surg 93(Suppl 1):79

    Google Scholar 

  89. Nagaraja V, Eslick GD, Cox MR (2014) The acute surgical unit model verses the traditional “on call” model: a systematic review and meta-analysis. World J Surg 38(6):1381–1387. doi:10.1007/s00268-013-2447-1

    Article  PubMed  Google Scholar 

  90. Pepingco L, Eslick GD, Cox MR (2012) The acute surgical unit as a novel model of care for patients presenting with acute cholecystitis. Med J Aust 196(8):509–510

    Article  PubMed  Google Scholar 

  91. Lau B, Difronzo LA (2011) An acute care surgery model improves timeliness of care and reduces hospital stay for patients with acute cholecystitis. Am Surg 77(10):1318–1321

    PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Ms. Sophie Pattison, Clinical Support Librarian, Medical Library, Royal Free Hospital, for her help with the literature search.

Funding

This article did not receive any funding from any source.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Author information

Authors and Affiliations

  1. University Department of Surgery, Royal Free Hospital and UCL Medical School, Pond Street, London, NW3 2QG, UK

    Rahul S. Koti, Christopher J. Davidson & Brian R. Davidson

Authors
  1. Rahul S. Koti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher J. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian R. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian R. Davidson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Koti, R.S., Davidson, C.J. & Davidson, B.R. Surgical management of acute cholecystitis. Langenbecks Arch Surg 400, 403–419 (2015). https://doi.org/10.1007/s00423-015-1306-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-015-1306-y

Keywords

Search

Navigation