Which patients may be treated for acute cholecystitis in an outpatient setting?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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For some patients with acute cholecystitis to be treated on an outpatient basis, the following patient criteria must be met:

  • Afebrile and normal vital signs

  • Minimal amount of pain and tenderness

  • No markedly abnormal laboratory results, normal common bile duct on ultrasonography, and no pericholecystic fluid or biliary air

  • No underlying medical problems (eg, diabetes, cirrhosis, vascular condition, steroids), advanced age, or pregnancy

  • Next day follow-up visit

Discharge on oral antibiotics and a small number of pain medications. In pregnancy, because symptoms may be recurrent, refer women to their obstetrician/gynecologist as well as a surgeon. Second trimester cholecystectomy is the safest time period, because the risk of premature labor is lower, and the uterus does not push on the gallbladder. [41]

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