Management of acute cholecystitis

Prabhava Bagla, Juan C. Sarria, Taylor S. Riall

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Purpose of review: Various aspects of the management of acute calculous cholecystitis, including type and timing of surgery, role of antibiotics, and nonoperative management, remain controversial. This review focuses on recently published studies addressing the timing of cholecystectomy, use of cholecystostomy tubes, and role of antibiotics in this condition. Recent findings: In most cases, the diagnosis of acute cholecystitis can be initially confirmed with an abdominal ultrasound. Early laparoscopic cholecystectomy (within 24-72 h of symptom onset) is better than delayed surgery (>7 days) for most patients with grade I and II diseases. Percutaneous cholecystostomy and novel endoscopic gallbladder drainage interventions may be used as a temporizing measure or as definitive therapy in those who are too sick to undergo surgery. Studies are conflicting as to whether antibiotics are required for the treatment of uncomplicated cases. Summary: Cholecystectomy remains the only definitive therapy for acute cholecystitis. Current guidelines recommend treatment on the basis of disease severity at presentation. Antibiotics and a variety of minimally invasive nonsurgical interventions, although not definitive, play an adjunctive role in the management of the disease.

Original languageEnglish (US)
Pages (from-to)508-513
Number of pages6
JournalCurrent opinion in infectious diseases
Issue number5
StatePublished - 2016


  • Acute cholecystitis
  • Cholecystostomy
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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