Chronic cholecystitis Health Article

Definition

Chronic cholecystitis is long-standing swelling and irritation of the gallbladder.

Alternative Names

Cholecystitis - chronic

Causes, incidence, and risk factors

Chronic cholecystitis is usually caused by repeated attacks of acute cholecystitis. This leads to thickening of the gallbladder walls. The gallbladder begins to shrink and eventually loses the ability to perform its function, which is concentrating, storing, and releasing bile.

The disease occurs more often in women than in men. The incidence increases after age 40. The main risk factors include the presence of gallstones (in which case, the symptoms are due to gallstones).

Symptoms

Attacks of upper abdominal pain, often with nausea or vomiting.

Signs and tests

Tests that reveal gallstones or inflammation in the gallbladder:

• Abdominal CT scan
• Abdominal ultrasound
• Gallbladder scan (HIDA scan)
• Oral cholecystogram

Treatment

Surgery is the usual treatment. Surgery to remove the gallbladder (cholecystectomy) can be performed as an open or laparoscopic procedure. The open procedure requires a large cut in the upper-right part of the abdomen. Laparoscopic surgery uses instruments and a small camera inserted through a cluster of a few small cuts.

In patients who are poor candidates for surgery because of other diseases or conditions, the gallstones may be dissolved with medication taken by mouth.

Expectations (prognosis)

Cholecystectomy is a common procedure with a low risk.

Complications

• Cancer of the gallbladder (rarely)
• Jaundice
• Pancreatitis
• Worsening of the condition

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

Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 159.