Chronic cholecystitis

Cholecystitis, CT scan

This is a CT scan of the upper abdomen showing cholecystitis (gall stones).

Also known as: Cholecystitis - chronic

Definition

Chronic cholecystitis is swelling and irritation of the gallbladder that persists over time.

The gallbladder is a sac located under the liver. It stores bile that is made in the liver. Bile helps the intestines digest fats.

Causes, incidence, and risk factors

Chronic cholecystitis is usually caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder.

These attacks cause the walls of the gallbladder to thicken. The gallbladder begins to shrink. Over time, the gallbladder is less able to concentrate, store, and release bile.

The disease occurs more often in women than in men, especially after age 40.

Symptoms

For symptoms of acute cholecystitis, see: Acute cholecystitis.

Acute cholecystitis is a painful condition that leads to chronic cholecystitis. It is not clear whether chronic cholecystitis causes any symptoms.

Signs and tests

Your health care provider may order the following blood tests:

Tests that reveal gallstones or inflammation in the gallbladder include:

Treatment

Surgery is the usual treatment. Surgery to remove the gallbladder is called cholecystectomy.

  • Laparoscopic cholecystectomy is most often done. This surgery uses smaller surgical cuts, which result in a faster recovery. Patients are often sent home from the hospital on the same day as surgery, or the next morning.
  • Open cholecystectomy requires a larger cut in the upper-right part of the abdomen.

In patients who are too ill to have surgery because of other diseases or conditions, the gallstones may be dissolved with medication taken by mouth. However, this may take 2 years or longer to work, and the stones may return after treatment.

Expectations (prognosis)

Cholecystectomy is a common procedure with a low risk.

Complications

Calling your health care provider

Call for an appointment with your health care provider if you develop any symptoms of cholecystitis.

Prevention

The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their gallbladder removed. However, the benefit of a low-fat diet has not been proven.

References

Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 65.

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Review date:
February 7, 2011
Reviewed by:
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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