Role of cholecystectomy in chronic acalculous cholecystitis

ABSTRACT

Chronic acalculous cholecystitis is a controversial disorder, and surgeons are reluctant to perform cholecystectomy in the absence of clear evidence of biliary calculi, this study described the clinical picture, investigations, and results of cholecystectomy in 20 patient diagnosed as having chronic acalculous cholecystitis. All the patients were from Al-Gubail hospital Saudi Arabia. They had right upper quadrant pain highly suggestive of gall bladder origin. In six patients ultrasonography and cholecystogrphy were completely normal, two patients showed evidence of biliary sludge in the gall bladder and in the remaining 12 patients the sole abnormality was ultasonographic demonstration of a thickened gall bladder wall. At assessment one year after cholecystectomy, 17 patients were completely relieved of symptoms, two were improved and only one patient failed to benfit. Despite the increasing sophistication of biliary tract investigative methods, the diagnosis of chronic acalculous cholecystitis remains predominantly clinical. In the presence of typical symptoms, and with exclusion of other upper abdominal pathology, cholecystectomy successfully relieves the majority of symptoms