What is the role of medical therapy in the management of biliary colic or acute cholecystitis?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Although surgical therapy is the treatment of choice for acute cholecystitis, many patients require hospitalization for stabilization and "cooling off" of the gallbladder before surgery. However, surgical consultation is appropriate, and depending on the institution, either medicine or surgery may admit the patient for conservative care. In addition, obtain an urgent gastroenterology consultation for endoscopic retrograde cholangiopancreatography (ERCP) in patients with evidence of choledocholithiasis (ie, common bile duct stones seen on ultrasonography, dilated common bile ducts, elevated liver function test results, pancreatitis).

Medical therapy of gallbladder colic includes antiemetics and pain control. In mild cholecystitis, in which inflammation is the primary process, antibiotics are prophylactic but are usually used. In acute cholecystitis, broad-spectrum antibiotic coverage is used.


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