MANAGEMENT OF ACUTE CHOLECYSTITIS: A NARRATIVE REVIEW

Abstract

Acute cholecystitis (AC) is a complex clinical condition that demands early diagnosis and appropriate management to prevent severe complications. This narrative review comprehensively addressed critical aspects related to the diagnosis, treatment, and management of AC. Ultrasonography emerged as pivotal in the initial diagnosis due to its high sensitivity and specificity, enabling precise identification of characteristic disease signs. Moreover, early laparoscopic cholecystectomy remains the treatment of choice in most cases, offering shorter hospital stays and quicker recovery for patients. Elderly patients pose a particular challenge due to their comorbidities and higher surgical risk, yet minimally invasive cholecystectomy has proven safe and effective when coupled with thorough perioperative assessment. During the COVID-19 pandemic, significant adaptations in AC management included expanded use of temporary non-surgical approaches such as percutaneous cholecystostomy to minimize viral exposure and preserve hospital resources. Overall, this review provides a comprehensive overview of acute cholecystitis, spanning clinical presentation, diagnostic methods, therapeutic options, and adaptations during the COVID-19 pandemic. Ultrasonography remains pivotal for early diagnosis, while laparoscopic cholecystectomy offers superior outcomes compared to open surgery. Elderly patients benefit from careful perioperative evaluation, and pandemic-related challenges prompted innovative approaches to manage acute cholecystitis effectively under constrained circumstances.