[Alithiasic cholecystitis in the adult: etiologies, diagnosis and treatment]

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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

E Vibert1, D Azoulay

  • 1Centre hépato-biliaire, hôpital Paul-Brousse, université Paris-Sud UPRES 1596, 94804 Villejuif, France.

Annales De Chirurgie
|July 4, 2002
PubMed

Insights

Acalculous cholecystitis, often caused by gallbladder ischemia in critically ill patients, requires surgical removal for definitive diagnosis and treatment. Percutaneous drainage is an alternative for high-risk patients.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Context:

  • Acalculous cholecystitis accounts for 2-14% of cholecystectomies for acute cholecystitis.
  • It primarily affects critically ill patients, often with cardiovascular disease or diabetes.
  • Gallbladder wall ischemia is the main etiology, though rare associations with HIV exist.

Purpose:

  • To review the etiology, diagnosis, and management of acalculous cholecystitis.
  • To highlight diagnostic challenges and treatment options.

Summary:

  • Diagnosis is challenging due to non-specific ultrasound findings for ischemic cholecystitis.
  • Cholecystectomy is the definitive treatment, providing a certain diagnosis.
  • Percutaneous drainage is reserved for patients unable to undergo anesthesia; medical management alone is insufficient.

Impact:

  • Clarifies the role of cholecystectomy as the gold standard treatment.
  • Provides guidance on alternative management strategies for high-risk patients.
  • Emphasizes the diagnostic limitations of current imaging modalities.

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