Last updated: 11/24/2009

Acute cholecystitis usually improves following conservative therapy in most patients. This conservative therapy involves the withholding of oral feedings, the use of intravenous feedings, and the administration of antibiotics and analgesics....

This is only a short-term alternative in hospitalized patients. Most of these patients should receive cholecystectomy within a few days to prevent recurrent attacks. In the short-term, patients often receive narcotic analgesics such as meperidine to relieve the intense pain associated with this condition. Patients who have evidence of gallbladder perforation or gangrene need to have an immediate cholecystectomy.

In patients with cholelithasis who are deemed unfit for surgery, alternative treatments are sometimes effective. These individuals often have symptom improvement after lifestyle changes and medical therapy. Lifestyle changes include dietary avoidance of foods high in polyunsaturated fats and gradual weight loss in obese individuals. Medical therapy includes the administration of oral bile salts. Patients with three or fewer gallstones of cholesterol composition and with a gallstone diameter less than 0.6 in (15 mm) are more likely to receive medical therapy and have positive results. The primary requirements for receiving medical therapy include the presence of a functioning gallbladder and the absence of calcification on computed tomography (CT) scans. Other non-surgical alternatives include using a solvent to dissolve the stones and using sound waves to breakup small stones. A major drawback to medical therapy is the high recurrence rate of stones in those treated.