| Theme | The Present State of Management of Acute Cholangitis and Cholecystitis | |
|---|---|---|
| Title | Surgical Management of Acute Cholecystitis | |
| Publish Date | 2015/09 | |
| Author | Yuichi Yamashita | Department of Gastroenterological Surgery, Fukuoka University |
| Author | Tomoaki Noritomi | Department of Gastroenterological Surgery, Fukuoka University |
| [ Summary ] | The TG13 updates the surgical treatment and timing for acute cholecystitis to reflect that optimal surgical treatments exist for each severity grade. For patients with mild acute cholecystitis, early laparoscopic cholecystectomy is the preferred procedure. Moderate acute cholecystitis generally requires early laparoscopic or open cholecystectomy within 72 hours after onset of acute cholecystitis. However, early gallbladder drainage is indicated for patients with severe local inflammation. In patients with severe acute cholecystitis, urgent management of organ dysfunction and gallbladder drainage are recommended to address severe local inflammation. Delayed elective cholecystectomy should be performed. Bile duct injury is a critical complication of laparoscopic cholecystectomy. Its incidence is around 0.6 %. The optimal time to perform cholecystectomy following percutaneous transhepatic gallbladder drainage remains controversial due to lack of strong evidence. |
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