Treatment of Uncomplicated Acute Calculous Cholecystitis in Patients Suitable for Surgery

Clinical Scenario

This protocol applies to uncomplicated acute calculous cholecystitis in a patient who is medically suitable for surgery and who is not declining surgical management.

Treatment Approach

Surgical intervention is the recommended first-line approach for this presentation. Early laparoscopic cholecystectomy is the preferred option, with timing guided by the interval from hospital admission and symptom onset. The full protocol specifies how anatomical findings, haemodynamic status, and the risk of iatrogenic injury determine the choice of surgical method — and the circumstances under which conversion or an alternative approach is indicated.

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References

DOI: 10.1186/s13017-020-00336-x

We recommend laparoscopic cholecystectomy as the first-line treatment for patients with ACC.
In the presence of adequate surgical expertise, we recommend ELC be performed as soon as possible, within 7 days from hospital admission and within 10 days from the onset of symptoms.
In uncomplicated ACC, we recommend against the routine use of postoperative antibiotics when the focus of infection is controlled by cholecystectomy.

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