Acute Cholecystitis: Symptoms, Emergency Treatment & Surgery

Acute cholecystitis is sudden gallbladder inflammation caused by a stone blocking the cystic duct, affecting 20% of symptomatic gallstone patients. Symptoms: persistent right upper abdominal pain >6 hours, fever 38-39°C, Murphy's sign positive, nausea, vomiting, loss of appetite. Graded by Tokyo Guidelines: Grade I (mild, no organ dysfunction), Grade II (moderate, elevated WBC, prolonged symptoms), Grade III (severe, organ dysfunction). Treatment: hospitalisation, nil-by-mouth, IV fluids, IV antibiotics, analgesia. Surgery: early laparoscopic cholecystectomy within 72 hours is recommended for Grade I and II — shorter hospital stay, lower conversion rate, eliminates recurrence risk. Grade III: ICU stabilisation, percutaneous cholecystostomy, delayed surgery. Dr. Adarsh M Patil performs early cholecystectomy for acute cholecystitis.