title: [Surgical treatment of acute cholecystitis].
abstract: Fundamental treatment for acute cholecystitis is cholecystectomy. However, the adoption of a treatment is dependend on degree of a severity of acute cholecystitis in each patient because its degree is influenced by factors such as duration from the onset of symptoms to medical examination. Early laparoscopic cholecystectomy is the preferred procedure for mild acute cholecystitis. Early cholecystectomy is also performed for moderately acute cholecystitis. However, if patients have severe local inflammation (gangrenous and purulent cholecystitis) early gallbladder drainage or open cholecystectomy is indicated. Emergency operation under adequate medical treatment is indicated for a patient with severe local inflammation of the gallbladder, torsion of the gallbladder, emphysematous cholecystitis, gangrenous cholecystitis, and purulent cholecystitis. Pericholecystic abscess, necrosis of the gallbladder wall, and perforation of the gallbladder can be diagnosed accurately by use of imaging diagnosis. The optimal surgical treatment for acute cholecystitis according to grade of severity should be performed referring to imaging findings.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka 814-0180.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Noritomi
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Matsuoka
authors.forename: Tomoshi
authors.initials: T
authors.lastname: Sinya
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sugi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Higa
authors.forename: Go
authors.initials: G
authors.lastname: Kusumoto
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nitahara
mesh_terms: D016058:Analgesia, Patient-Controlled; D000758:Anesthesia; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D004632:Emergency Medical Services; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control; D019990:Perioperative Care; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D013997:Time Factors