Medical Treatment Options

What are my options? Medical options for cholecystitis are dependent on the severity of symptoms the patient may be having. For acute cholecystitis, commonly broad spectrum antibiotics are administered in case of infection present; the benefit is unclear as to why it is beneficial. Another option is for a percutaneous catheter drainage or endoscopic catheter with a stent to relieve the obstruction is also another option. If the cholecystitis has progressed it can cause more complicated injuries to the body. Other options for complicated progressive cholecystitis are, Open cholecystectomy or Laparoscopic cholecystectomy. 

Laparoscopic cholecystectomy is the removal of the gallbladder through one of the four small incisions either by electrosurgical or laser excision. Benefit of this procedure is minimal scarring, less postop pain and a shortened hospital stay. This is the major invention for medical treatment nowadays for cholecystitis. 
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Open cholecystectomy is defined as the removal of the gallbladder through one incision (bigger). Patients may have an open surgery instead of laparoscopic due to not being able to remove gallbladder through the small incisions or if needed, more room to perform the procedure. More scarring occurs, bigger incision site, longer hospital stay etc. There are still more methods used especially seen in elderly patients who have high risks during surgery and cannot undergo surgery. Chemodissolution is the use of chemicals to dissolve gallstones, like bile acids. Ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) are the common agents used. Lithotripsy is used as well, defined as the breaking up of gallstones using shock waves.This allows the stones to break up and allow for the stones to be small enough to pass through the cystic duct and let the gallbladder function in a normal state.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.