Clinical Gastroenterology Vol.30 No.10(5-2)

Theme The Present State of Management of Acute Cholangitis and Cholecystitis
Title Essential Strategy for the Treatment of Acute Cholecystitis
Publish Date 2015/09
Author Naotaka Fujita Miyagi Medical Check‒up Plaza
[ Summary ] Acute cholecystitis is one of the most common biliary disorders encountered in daily clinical practice. Guidelines for the management of acute cholangitis and cholecystitis was first published in 2005 and has been revised in 2013. According to the guidelines, early performance of cholecystectomy, especially laparoscopic cholecystectomy, is the essential treatment of choice for this condition. Assessment of the severity of cholecystitis is crucial for the determination of treatment. Gallbladder drainage should be considered and performed when a patient does not respond to the initial conservative treatment and urgent cholecystectomy is not available, or shows the severity of moderate or severe grade. Gallbladder drainage is quite effective in the control of acute inflammation and improvement of general condition, and ultrasonography‒guided transcutaneous transhepatic gallbladder drainage is the standard technique. Elective cholecystectomy is recommended after improvement of acute inflammation.
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