Cholecystitis Support Group

Cholecystitis is inflammation of the gallbladder. It is commonly due to impaction (sticking) of a gallstone within the neck of the gall bladder, leading to inspissation of bile, bile stasis, and infection by gut organisms. Cholecystitis may be a cause of right upper quadrant pain. The pain may actually manifest in the right flank or scapular region at first. In severe cases, the gall bladder can rupture and form an abscess. In severe cases, it may lead to a life-threatening infection of the liver called ascending cholangitis. In other cases, it may lead to a stable inflammatory state termed chronic cholecystitis.

Although antibiotics will often help reduce the inflammation of the gallbladder, acute cholecystitis is an indication for gallbladder removal (cholecystectomy). This can be accomplished with an open surgery or a laparoscopic procedure. Laparoscopic procedures can have less morbidity and a shorter recovery stay. An open procedure is preferred by many surgeons if the gallbladder is so inflamed that it could fall apart with the manipulations that could be needed with a laparoscopic procedure. A laparoscopic procedure may also be 'converted' to an open procedure during the operation if the surgeon feels that further attempts at laparoscopic removal might harm the patient.

In cases of severe inflammation, shock, or if the patient has higher risk for general anesthesia (required for cholecystectomy), the managing physician may elect to have an interventional radiologist insert a percutaneous drainage catheter into the gallbladder ('percutaneous cholecystostomy tube') and treat the patient with antibiotics until the acute inflammation resolves. The patient may later warrant cholecystectomy if their condition improves.

Gallbladder rupture is a possible but an unusual complication of cholecystitis. Approaches to this complication will vary based on the condition of an individual patient, the evaluation of the treating surgeon or physician, and the facilities' capability.