Clinical study of acute cholecystitis and its management in a tertiary care hospital

Background: Acute cholecystitis is an inflammation of the gallbladder which results as a common complication of gallstone disease and is a frequent cause of this abdominal emergency, especially among middle-aged women. Despite laparoscopic cholecystectomy being firmly established as the surgical treatment of gallstone disease, converting to open cholecystectomy may be necessary in difficult anatomy and severe gallbladder disease. Aims and Objectives: This study is to evaluate the incidence of disease in different age groups and genders, the diagnosis and various modalities of treating acute cholecystitis. Methods: Prospective observational study conducted in DR. PSIMS&RF, a tertiary care teaching hospital from December 2022 to November 2024. Results: In this study, acute cholecystitis was more common in middle aged female patients. Patients presented with symptoms like pain abdomen, fever, vomiting, dyspepsia and jaundice and signs like guarding in right hypochondrium, tenderness in right hypochondrium, positive Murphy’s sign and palpable gallbladder. Ultrasound abdomen is done in all cases and CT scan in selected patients. Out of 50 patients studied, 40 patients were planned for laparoscopic cholecystectomy, out of which 35 patients underwent successful laparoscopic cholecystectomy, 4 cases got converted into open cholecystectomy and 1 patient underwent open cholecystostomy. 10 patients were managed conservatively and planned for interval cholecystectomy, 4 patients had come back and laparoscopic cholecystectomy was successfully performed on them. 6 patients were lost to follow-up. Conclusion: Acute cholecystitis is a common cause of upper abdominal pain. It is seen in 10% of patients with gallstones. Delay in the presentation of acute cholecystitis will lead to complications like empyema gallbladder, gangrenous cholecystitis, and gallbladder perforation.