Cholecystitis

Diagnosis

To diagnose cholecystitis, your healthcare professional performs a physical exam and reviews your symptoms and medical history. The following tests and procedures are commonly used:

• Blood tests: These help detect signs of infection or other gallbladder-related problems.
• Imaging tests: Techniques such as abdominal ultrasound, endoscopic ultrasound, CT scan, or magnetic resonance cholangiopancreatography (MRCP) create images of your gallbladder and bile ducts. These can reveal inflammation or gallstones.
• HIDA scan (hepatobiliary iminodiacetic acid scan): This test tracks bile production and flow from the liver to the small intestine using a radioactive dye. It helps identify blockages in the bile ducts.

Treatment

Cholecystitis treatment usually requires hospitalization to manage inflammation and infection in the gallbladder. In some cases, surgery may be necessary.

During your hospital stay, treatments may include:
• Fasting: You may be restricted from eating or drinking to reduce strain on the inflamed gallbladder.
• IV fluids: Administered to prevent dehydration.
• Antibiotics: Used to fight infection if present.
• Pain medication: Helps relieve pain and discomfort.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): This procedure uses dye and imaging to locate and remove stones blocking the bile ducts.
• Gallbladder drainage (Cholecystostomy): If surgery isn’t possible, a drainage tube may be placed through the abdomen (percutaneous drainage) or endoscopically through the mouth (endoscopic drainage) to remove infection.

Most patients begin to feel better within 2–3 days. However, inflammation often recurs, and surgery is typically required to prevent future episodes.

Gallbladder Removal Surgery (Cholecystectomy)

The gallbladder is usually removed through a minimally invasive procedure called laparoscopic cholecystectomy, which involves several small incisions in the abdomen.
In rare cases, open surgery with a larger incision may be required.

The timing of surgery depends on the severity of symptoms and surgical risk. For most patients, the gallbladder is removed during the initial hospital stay.

After removal, bile flows directly from the liver to the small intestine, and digestion continues normally without the gallbladder.