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What Is Acalculous Cholecystitis? What Are Its Implications? How Is It Managed?

  • Manpreet SinghEmail author
Chapter

Abstract

Acalculous cholecystitis (ACC) typically occurs in patients with underlying, severe comorbid medical or surgical conditions. It has increased morbidity and mortality compared to cholecystitis due to gallstones. ACC is difficult to diagnose but should be considered in elderly, hospitalized, or immune-compromised patients with fever and abdominal pain. Although cholecystectomy is the preferred treatment, many patients with ACC are poor surgical candidates because of their underlying comorbid conditions or clinical status. Thus treatment often initially involves percutaneous or endoscopic intervention and antibiotics.

Keywords

Acalculous cholecystitis (ACC) Percutaneous cholecystostomy 

References

  1. 1.
    Barie PS, Eachempati SR. In: Dultz LA, Todd SR, Eachempati SR, editors. Acute cholecystitis. Cham: Springer International Publishing; 2015.Google Scholar
  2. 2.
    Treinen C, Lomelin D, Krause C, Goede M, Oleynikov D. Acute acalculous cholecystitis in the critically ill: risk factors and surgical strategies. Langenbeck’s Arch Surg. 2015;400:421–7.  https://doi.org/10.1007/s00423-014-1267-6.CrossRefGoogle Scholar
  3. 3.
    Tana M, Tana C, Cocco G, Iannetti G, Romano M, Schiavone C. Acute acalculous cholecystitis and cardiovascular disease: a land of confusion. J Ultrasound. 2015;18(4):317–20.CrossRefGoogle Scholar
  4. 4.
    Theodorou P, Maurer CA, Spanholtz TA, et al. Acalculous cholecystitis in severely burned patients: incidence and predisposing factors. Burns. 2009;35(3):405–11.CrossRefGoogle Scholar
  5. 5.
    Hamp T, Fridrich P, Mauritz W, Hamid L, Pelinka LE. Cholecystitis after trauma. J Trauma. 2009;66(2):400–6.CrossRefGoogle Scholar
  6. 6.
    Gu MG, Kim TN, Song J, Nam YJ, Lee JY, Park JS. Risk factors and therapeutic outcomes of acute acalculous cholecystitis. Digestion. 2014;90(2):75–80.CrossRefGoogle Scholar
  7. 7.
    Joseph T, Unver K, Hwang GL, et al. Percutaneous cholecystostomy for acute cholecystitis: ten-year experience. J Vasc Interv Radiol. 2012;23(1):83–8.e1.CrossRefGoogle Scholar
  8. 8.
    Chung YH, Choi ER, Kim KM, et al. Can percutaneous cholecystostomy be a definitive management for acute acalculous cholecystitis? J Clin Gastroenterol. 2012;46(3):216–9.CrossRefGoogle Scholar
  9. 9.
    Noh SY, Gwon DI, Ko GY, Yoon HK, Sung KB. Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients. Eur Radiol. 2018;28(4):1449–55.CrossRefGoogle Scholar
  10. 10.
    Soria Aledo V, Galindo Iniguez L, Flores Funes D, Carrasco Prats M, Aguayo Albasini JL. Is cholecystectomy the treatment of choice for acute acalculous cholecystitis? A systematic review of the literature. Rev Esp Enferm Dig. 2017;109(10):708–18.PubMedGoogle Scholar
  11. 11.
    Irani S, Baron TH, Grimm IS, Khashab MA. EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video). Gastrointest Endosc. 2015;82(6):1110–5.CrossRefGoogle Scholar
  12. 12.
    Anderson JE, Inui T, Talamini MA, Chang DC. Cholecystostomy offers no survival benefit in patients with acute acalculous cholecystitis and severe sepsis and shock. J Surg Res. 2014;190(2):517–21.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Emergency MedicineDavid Geffen School of Medicine at UCLA, Harbor-UCLA Medical CenterTorranceUSA

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