Acalculous Cholecystitis Workup

  • Author: Homayoun Shojamanesh, MD; Chief Editor: John Geibel, MD, DSc, MA   more...
 
Updated: Jan 5, 2012
 

Laboratory Studies

  • CBC count, liver function tests, and blood culture tests are some of the main laboratory tests that should be performed. Bile culture results are negative in nearly 50% of patients with acalculous cholecystitis, probably because of concurrent antibiotic therapy in these patients.
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Imaging Studies

  • Perform ultrasound or computed tomography (CT) scanning of the abdomen.
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Procedures

  • For surgical candidates, perform cholecystectomy using an open or laparoscopic approach as indicated.
  • For patients who are not surgical candidates, perform percutaneous cholecystostomy.[5, 6]
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Homayoun Shojamanesh, MD  Former Fellow, Digestive Diseases Branch, National Institutes of Health

Homayoun Shojamanesh, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Coauthor(s)

Praveen K Roy, MD, AGAF  Gastroenterologist, Ochsner Clinic Foundation; Adjunct Associate Research Scientist, Lovelace Respiratory Research Institute; Editor-in-Chief, The Internet Journal of Gasteroenterology; Editorial Board, Signal Transduction Insights; Editorial Board, The Internet Journal of Epidemiology; Editorial Board, Gastrointestinal Endoscopy Review Letter

Praveen K Roy, MD, AGAF is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society of Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Specialty Editor Board

Marco G Patti, MD  Professor of Surgery, Director, Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine

Marco G Patti, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Gastroenterological Association, American Medical Association, American Surgical Association, Association for Academic Surgery, Pan-Pacific Surgical Association, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, Southwestern Surgical Congress, and Western Surgical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael A Grosso, MD  Consulting Staff, Department of Cardiothoracic Surgery, St Francis Hospital

Michael A Grosso, MD is a member of the following medical societies: American College of Surgeons, Society of Thoracic Surgeons, and Society of University Surgeons

Disclosure: Nothing to disclose.

Paolo Zamboni, MD  Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy

Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA  Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director, Surgical Research, Department of Surgery, Yale-New Haven Hospital

John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract

Disclosure: AMGEN Royalty Consulting; ARdelyx Ownership interest Board membership

References

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  3. Basar O, Kisacik B, Bozdogan E, et al. An unusual cause of acalculous cholecystitis during pregnancy: hepatitis A virus. Dig Dis Sci. Aug 2005;50(8):1532. [Medline].

  4. Fuoti M, Pinotti M, Miceli V, et al. [Acute acalculous cholecystitis as a complication of hepatitis A: report of 2 pediatric cases] [Italian]. Pediatr Med Chir. Mar-Apr 2008;30(2):102-5. [Medline].

  5. Joseph T, Unver K, Hwang GL, Rosenberg J, Sze DY, Hashimi S, et al. Percutaneous Cholecystostomy for Acute Cholecystitis: Ten-Year Experience. J Vasc Interv Radiol. Nov 29 2011;[Medline].

  6. Chung YH, Choi ER, Kim KM, Kim MJ, Lee JK, Lee KT, et al. Can Percutaneous Cholecystostomy be a Definitive Management for Acute Acalculous Cholecystitis?. J Clin Gastroenterol. Aug 2 2011;[Medline].

  7. Casillas RA, Yegiyants S, Collins JC. Early laparoscopic cholecystectomy is the preferred management of acute cholecystitis. Arch Surg. Jun 2008;143(6):533-7. [Medline].

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  17. Kageoka M, Watanabe F, Maruyama Y, et al. Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis. Dig Endosc. Jul 2009;21(3):170-5. [Medline].

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