Current Management of Acute Calculous Cholecystitis

Abstract

Provide a comprehensive review of the latest reports on management of acute calculous cholecystitis and our current practices The diagnosis of acute calculous cholecystitis (ACC) should be driven by a combination of clinical, laboratory, and imaging findings. The use of grading scales to classify the severity of ACC has successfully predicted the morbidity of surgical management of this disease. Surgical management has shifted from open cholecystectomy or delayed laparoscopic cholecystectomy to early laparoscopic cholecystectomy. If the critical view of safety (CVS) cannot safely be obtained, a change in surgical strategy with either conversion to open or a subtotal laparoscopic cholecystectomy should be considered. For patients that are not surgical candidates, treatment includes antibiotics and biliary drainage with percutaneous cholecystostomy tube. Early laparoscopic cholecystectomy is the gold standard for the treatment of ACC. The use of grading scales to guide operative management should be employed.