cholecystitis



Overview

What is cholecystitis?

Definition.

Cholecystitis is an acute and chronic inflammatory response of the gallbladder caused by obstruction of the cystic duct, bacterial infection, or chemical irritation.

Classification

Acute cholecystitis: It is one of the common acute abdominal diseases. About 95% of patients have gallbladder stones, called stone cholecystitis; about 5% of patients without gallbladder stones, called non-stone cholecystitis.

Chronic cholecystitis: It is usually a chronic inflammation of the gallbladder caused by long-standing gallbladder stones, or recurrent and prolonged by acute cholecystitis.

Calculous cholecystitis: Inflammatory reaction of the gallbladder wall occurs when gallbladder stones are embedded and lead to poor bile drainage, or when bacterial infection causes damage to the gallbladder mucosa.

Non-calculous cholecystitis: cholecystitis in which no stone is seen in the routine preoperative examination as well as intraoperatively, mostly due to infection, impaired gallbladder emptying, gallbladder ischemia, metabolism and other factors.

Morbidity

Cholecystitis is a relatively common disease of the digestive system.

There is no national epidemiologic data on this disease, and the prevalence of cholecystitis in Songjiang area of Shanghai is 3.91%. The prevalence of cholecystitis in Zhenhai, Ningbo is 1.42%.

Acute calculous cholecystitis is more common in women, 3 times more common in men before the age of 50, and 1.5 times more common in men after the age of 50.

Acute noncalculous cholecystitis occurs more often in the elderly seriously ill patients.

Questions you may be concerned about

Is it true that you can’t eat 5 foods with cholecystitis?

Not true. Patients with cholecystitis should quit smoking and drinking, avoid spicy, greasy food and stimulating food, and choose a low-fat, high protein, high fiber diet on a daily basis. Consumption of fatty meat, animal offal, fried food, etc. may induce cholecystitis attacks. Vegetable oils such as vegetable oil, soybean oil, peanut oil, sesame oil, etc. can be chosen in daily life; increase the intake of fresh vegetables and fruits; fish, shrimp, lean meat, rabbit, chicken, tofu, etc. rich in high-quality protein are recommended.

Where is the location of cholecystitis pain?

The pain is located in the right upper abdomen and may also radiate to the right shoulder and back, and often comes on after a full meal or eating greasy food.

Acute cholecystitis may start as a paroxysmal colic and gradually develop into a constant distending pain; chronic cholecystitis is often felt after eating and belching.

What is the most effective medicine to cure cholecystitis?

There is no specific medicine for cholecystitis.

The main treatment is pain relief, anti-inflammatory, choleretic, antispasmodic, lithotripsy and other symptomatic treatment. Antispasmodic drugs, usually magnesium sulfate, scopolamine, etc.; anti-inflammatory drugs are often cephalosporin III or quinolone antibiotics. Choleretic drugs are mainly anti-inflammatory choleretic tablets of proprietary Chinese medicines; and stone-dissolving drugs are mainly ursodeoxycholic acid tablets and so on.

For cholecystitis that does not respond to conservative treatment with medication, surgery may need to be considered.

Can cholecystitis heal on its own?

Cholecystitis does not usually heal on its own.

If the inflammation is not severe, the gallbladder can return to its normal shape and the clinical symptoms will gradually disappear through proper rest and dietary adjustments.

However, if minor cholecystitis is not regulated in time, the symptoms may recur on the one hand, and on the other hand, it may gradually aggravate and cause serious clinical symptoms, which is also known as chronic cholecystitis.

Causes

Causes

Different types of cholecystitis have different causes.

Common causes include obstruction of the gallbladder duct and gallbladder stones, accounting for 80% to 95%; other causes of obstruction include biliary roundworms, gallbladder tumors, gallbladder torsion, and narrowing of the gallbladder duct.

Bacterial invasion, bacteria can be through the biliary tract or blood circulation to the gallbladder to cause infection.

Chemical irritation, such as bile acid salts, reflux of pancreatic fluid, etc.

Acute stone cholecystitis

Stones move to the vicinity of the gallbladder duct, which may block the duct or become embedded in the neck of the gallbladder, directly damaging the mucosa.

Bacteria enter the gallbladder retrogradely through the bile duct, or through the blood circulation or lymphatic route, causing infection when bile outflow is poor. The main causative organisms are gram-negative bacilli, often combined with anaerobic infections.

Acute non-stone cholecystitis

Acute non-calculous cholecystitis accounts for about 5%, the etiology of which is not clear. It is most common in severe trauma, burns, prolonged parenteral nutrition, abdominal non-biliary major surgery (e.g. abdominal aortic aneurysm surgery), shock, systemic infection, septicemia and other critical patients.

Chronic stone cholecystitis

Gallbladder stones are the main cause of chronic cholecystitis. Stones can lead to recurrent obstruction of the gallbladder duct and cause damage to the gallbladder mucosa, with recurrent inflammatory reactions of the gallbladder wall, scar formation and gallbladder dysfunction.

When the gallbladder or bile duct becomes embedded and obstructed, enterogenic bacterial infections may result.

Common pathogenic bacteria include Escherichia coli, Bacillus immobilis, and Proteus mirabilis.

Low-fiber, high-energy diets can increase bile cholesterol saturation and facilitate stone formation.

Certain medications can lead to gallbladder stone formation, such as ceftriaxone and birth control pills.

Rapid weight loss, such as irrational weight loss methods, may predispose to gallbladder stone formation.

Chronic non-stone cholecystitis

Intestinal bacteria may travel through the bile ducts to the gallbladder, or may reach the gallbladder by the blood or lymphatic route.

Parasitic and viral infections are a rare cause of chronic cholecystitis, such as Ascaris lumbricoides, Pearly Flagellates, and Human Immunodeficiency Virus.

Obstructed emptying of the gallbladder leads to prolonged emptying time, bile stasis in the gallbladder, gallbladder enlargement, gradual fibrosis of the gallbladder wall and chronic inflammatory cell infiltration, which is an important etiology of chronic non-struvite cholecystitis.

Certain causes of bile acid metabolism disorder, bile salt long-term chemical stimulation, can also cause chronic gallbladder inflammation.

Vascular lesions of the gallbladder wall, major non-biliary surgery, and severe illnesses such as sepsis and shock may lead to long-term dilatation of the gallbladder mucosa and localized ischemia and necrosis, and chronic cholecystitis.

Pathogenesis

Acute stone cholecystitis

Small stones in the gallbladder become embedded in the neck of the gallbladder, causing acute obstruction, resulting in increased intracystic pressure and inability of bile to pass through the neck of the gallbladder and the cystic duct.

Local release of inflammatory factors after obstruction, including lysophospholipids and prostaglandin A, causes acute inflammation.

When the gallbladder is poorly drained or obstructed, the internal environment of the gallbladder favors bacterial growth, causing acute inflammation.

Chronic cholecystitis

Chronic calculous cholecystitis: irritation and obstruction of stones in the gallbladder ducts cause bile to pool in the gallbladder and form chronic inflammation.

Chronic non-calculous cholecystitis: can be caused by acute cholecystitis, or due to the presence of congenital anatomical factors or chronic pancreatitis, which makes it difficult for the gallbladder to empty.

Risk factors

Obesity.

Advanced age.

Suffering from gallbladder stones, diabetes mellitus, liver cirrhosis, chronic pancreatitis, etc.

Long-term alcohol consumption, high-calorie diet, irregular diet.

Long-term use of contraceptive pills.

Symptoms

Main Symptoms

Acute cholecystitis

The right upper abdomen may begin as paroxysmal colicky pain, gradually progressing to a constant distending pain, which often comes on after a full meal or eating greasy food, and the pain may radiate to the right shoulder and back.

It is a common symptom, and if nausea and vomiting are persistent or frequent, it can cause dehydration, collapse, and electrolyte disturbances, most often when stones or roundworms obstruct the gallbladder duct.

There is often a mild to moderate fever, usually without chills, and there may be a fear of cold. The presence of chills and high fever indicates a serious condition, such as gangrene, perforation of the gallbladder or gallbladder pus, or a combination of acute cholangitis.

Less commonly, jaundice (yellowing of the skin, whites of the eyes, urine, etc.) is often indicative of liver damage due to pericholecystitis, or obstruction of the bile ducts, which suggests an aggravation of the condition.

Chronic cholecystitis

Chronic cholecystitis has a slow onset and can be caused by recurrent episodes of acute cholecystitis, characterized by alternating acute episodes and remissions. Symptoms in the acute stage are the same as those in acute cholecystitis; in the remission stage, there may not be any symptom, or there may only be discomfort and nausea in the right upper abdomen.

Mostly occur a few hours after a full meal or at night, after eating feel fullness discomfort, belching (burp), may also appear in the right upper abdomen or the back of the shoulder hidden pain, can be recurrent, eating greasy, high-fat food aggravated.

There can be a feeling of hating greasy food.

Complications

Gallbladder perforation: manifested by severe pain in the right upper abdomen, nausea and vomiting.

Acute pancreatitis: sudden onset of severe pain in the upper abdomen, often accompanied by nausea and vomiting. In severe cases, dehydration occurs and blood pressure falls sharply thus leading to dizziness.

Acute diffuse peritonitis: manifested by abdominal pain, nausea, vomiting; systemic manifestations may include fever and toxemia, and in severe cases, a drop in blood pressure and signs of shock.

Consultation

Department of Medicine

General Surgery

Consult the doctor promptly for symptoms such as persistent severe pain in the right upper abdomen, nausea and vomiting, fever and chills.

Emergency Department

If you experience persistent colic, frequent vomiting, high fever, low blood pressure, blurred consciousness, etc., go to the Emergency Department immediately.

Preparation for medical treatment

Preparing for your visit to the emergency department: registration, preparation of documents, and frequently asked questions.

Tips

Try to keep a record of the symptoms you have experienced and how long they have lasted before you go to the emergency room.

Do not take painkillers by mouth before the visit, as this may affect the doctor’s judgment of your condition.

Preparation Checklist

Pay particular attention to the time of onset of symptoms, special performance, etc.

What is the discomfort? How long has it lasted?

Is there any abdominal pain?

Has the epigastric pain worsened after eating fatty foods? What is the level of pain?

Any fever?

Any other discomfort?

Do you eat regularly? Do you eat breakfast every day?

Do you like to eat greasy or light food?

How much water do you drink every day?

Have you ever had similar problems before?

Do you have any history of gallbladder stones or bile duct stones?

Have you had any checkups or treatments? What is the effect?

Any special medications (birth control pills, etc.)?

Test results in the last six months, which can be brought to the doctor’s office.

Blood test

Abdominal ultrasound, CT, MRI

Medications in the last 3 months, if available in boxes or packages, bring with you to the doctor’s office

Antibiotics: Ceftriaxone

Contraceptives: megestrol acetate, norethindrone tablets

Diagnosis

Diagnosis is based on

Medical history

Possible past history of cholelithiasis, hepatitis, cirrhosis, chronic pancreatitis, lipid metabolic disorders, etc.

Clinical manifestations

Acute attack may present with right upper abdominal pain, fever, nausea and vomiting.

Pressure pain may be present in the right upper abdomen.

Positive Murphy’s sign: Pressing the right upper abdomen under the rib margin and asking the examinee to take abdominal breathing, the examinee appears to have a sudden inspiratory pause due to pain, which is a typical sign of acute cholecystitis.

Laboratory tests

By checking the white blood cell count and neutrophil ratio, the presence of acute bacterial infection can be determined and the diagnosis can be aided.

A significant increase in leukocytes and neutrophil ratio suggests that the gallbladder is septic or even gangrenous.

Serum glutamine transaminase and alkaline phosphatase are often elevated, serum bilirubin is elevated in about 1/2 of the patients, and serum amylase is elevated in 1/3 of the patients.

Imaging

Abdominal ultrasound is a diagnostic method to confirm the diagnosis of cholecystitis, which can determine the size of the gallbladder, thickening of the gallbladder wall, and the presence of stones.

Acute cholecystitis may show thickening of the gallbladder wall (>3 mm). Bilateral signs of thickening of the gallbladder plasma membrane edema manifested, pericholecystic effusion, destruction of the gallbladder mucosa, and gallbladder pneumatosis.

When ultrasound finds stone shadow in the gallbladder or when ultrasound diagnosis is difficult, CT and magnetic resonance imaging (MRI) can be used to further clarify the diagnosis.

Avoid wearing metal jewelry or clothing with metal button fittings during the examination.

Diagnostic Criteria

Acute cholecystitis

Symptoms: acute pain in the right upper abdomen, often accompanied by fever, nausea and vomiting.

Signs and symptoms: right upper abdominal pressure and pain, accompanied by rebound pain, abdominal muscle tension, Murphy’s sign is positive.

Laboratory tests: Increased blood leukocyte count and neutrophil count.

Ultrasonography: increased gallbladder wall volume (≥4 cm transverse gallbladder diameter), gallbladder wall edema, thickened (≥3 mm) or furrowed gallbladder wall.

Chronic cholecystitis

Symptoms: recurrent right upper abdominal distension or discomfort is the most common symptom, which may be accompanied by abdominal distension, belching, anorexia of grease and other dyspeptic symptoms.

Signs: Mild pressure and percussion pain in the right upper abdomen can be seen on physical examination, but most patients may not have any positive signs.

Ultrasonography: The gallbladder volume is often reduced or normal, or slightly increased, with thickened (≥3 mm) or rough gallbladder wall.

Differential diagnosis

Acute appendicitis

Similarities: abdominal pain, fever, etc.

Differences: the pain of acute cholecystitis is in the right upper abdomen, while that of appendicitis is in the right lumbar region or the upper part of the right lower abdomen; in acute cholecystitis, the enlarged gallbladder can be palpated under the costal margins and there are signs of gallbladder tenderness and Murphy’s sign, which can be differentiated from appendicitis.

Chronic gastritis

Similarities: abdominal pain, abdominal distension, etc.

Differences: Chronic gastritis may manifest as vague pain in the upper abdomen, acid reflux, belching, etc. It can be differentiated by gastroscopy or ultrasonography.

Gastroesophageal reflux disease

Similarity: abdominal pain, etc.

Differences: GERD manifests as retrosternal pain, acid reflux and heartburn, which mostly occurs after a full meal, aggravated by lying down after the meal, and alleviated by standing or semi-recumbent position. It can be identified by gastroscopy and esophageal pH monitoring or ultrasonography.

Gallbladder Cancer

Similarities: nausea, vomiting, etc.

Differences: Early symptoms of gallbladder cancer are similar to chronic cholecystitis, but most of them are painless enlargement of gallbladder, which can be identified by ultrasonography.

Acute pancreatitis

Similarity: abdominal pain and fever.

Differences: abdominal pain in acute pancreatitis is mostly located in the middle or left side of the epigastrium; physical signs are not as obvious as that of acute cholecystitis; Murphy’s sign is negative; elevation of serum amylase is significant; ultrasound shows enlarged pancreas with unclear boundary without acute cholecystitis; CT examination is more reliable than ultrasound in the diagnosis of acute pancreatitis, and ultrasound often shows unclear pancreas due to distention in the abdomen.

Treatment

If the condition of acute simple cholecystitis has a tendency to remission, fasting, antispasmodic, antibiotics, fluid replacement and other therapeutic measures can be taken to wait for the condition to be relieved after elective surgery.

If there is no remission and the diagnosis is acute purulent or gangrenous perforated cholecystitis, emergency surgical treatment is required. If the gallbladder is not perforated, cholecystectomy is feasible if the patient can tolerate surgery.

If the patient is old and the cardiopulmonary and renal functions cannot tolerate the surgery, percutaneous transhepatic cholecystectomy or cholecystostomy is feasible; for those with perforated gallbladder, emergency surgery should be performed to remove the gallbladder, clean up the abdominal cavity adequately, and drain the gallbladder.

Acute phase treatment

Non-surgical treatment

Acute attacks of fever, vomiting, severe pain, fasting, anti-infection, antispasmodic, rehydration, nutritional support, correction of water electrolyte and acid-base balance imbalance. After remission, elective surgery is performed.

Indications for emergency surgery

The onset of the disease within 48 to 72 hours.

Ineffective non-surgical treatment or worsening condition.

Perforation of gallbladder, diffuse peritonitis, complication of acute suppurative cholangitis, etc.

Acute noncalculous cholecystitis is prone to gangrene and perforation, and should be treated with surgery as soon as it is diagnosed.

General treatment

A low-fat diet is recommended, do not overeat, and promote a regular diet with quantitative and regular timing.

Actively prevent and treat bacterial infections and complications, pay attention to dietary hygiene, prevent the occurrence of biliary parasites, and actively treat intestinal ascariasis.

Living and living in a controlled manner, pay attention to the combination of work and rest, appropriate temperature and cold, maintain optimism and smooth bowel movement.

If the disease has stones, or frequent attacks, surgical treatment can be considered.

Medication

The main role of drug therapy is anti-infection, antispasmodic, analgesic. The application of drugs must strictly follow the doctor’s instructions, not unauthorized use.

Antispasmodic and analgesic drugs

Clinical use of scopolamine (654-2) and other anticholinergic drugs intramuscular injection or intravenous injection, severe pain can be intramuscular injection of iproniazine, pethidine to enhance the analgesic effect.

Antibiotics

Escherichia coli, Klebsiella and enterococci are the main pathogens of cholecystitis, and antibiotics effective against these pathogens, such as cephalosporins, quinolones and metronidazole, should be selected.

The choice of antibiotics should be based on clinical symptoms, bacterial culture (blood or bile) and drug sensitivity tests.

Choleretic drugs

Dehydrocholic acid and ursodeoxycholic acid are commonly used.

Proprietary Chinese medicines

Anti-inflammatory choleretic tablets for acute cholecystitis, cholangitis, hepatobiliary damp-heat syndrome.

Bile and Gastric Health Capsules, used for dystocia, jaundice and bile reflux gastritis caused by liver and gallbladder damp-heat syndrome, and cholecystitis with the above symptoms.

Biliary Ning Tablets, for chronic cholecystitis with liver depression and stagnation of qi, and uncleared damp-heat syndrome.

Gallstone Litong Tablets, for gallstone disease with Qi stagnation.

Surgery

Indications for surgery

Purulent gangrenous cholecystitis.

After active non-surgical treatment, the condition continues to develop and worsens.

Acute peritonitis with high suspicion of gallbladder lesion, who have no improvement after non-surgical treatment.

Surgical methods

Laparoscopic cholecystectomy or open cholecystectomy can be used.

Laparoscopic cholecystectomy has the advantages of less trauma and faster postoperative recovery, but it is not suitable for those who suffer from heart disease and poor cardiopulmonary function.

If in the process of laparoscopic cholecystectomy, it is found that the gallbladder is heavily inflamed, densely adhered to the surrounding tissues, and the anatomical structure is not clear, etc., it should be decisively relayed to open the abdomen to ensure safety.

It is mainly applied to some elderly patients who are in poor general condition or with serious cardiopulmonary diseases and are estimated to be unable to tolerate general anesthesia; or those whose gallbladder is severely and tightly adhered to the surrounding tissues and whose anatomy is unclear, thus making the surgical operation very difficult.

Ostomy can be performed first to reduce pressure and drainage, and then cholecystectomy can be performed after 3 months.

It is suitable for patients with septic cholecystitis who are in critical condition and are not suitable for surgery.

Refresh

Postoperative care

Be careful not to soil the gauze covering the wound. If it is soiled accidentally, you should find a doctor to change it and not change it by yourself.

Pay attention to whether there is any redness and swelling around the wound, and whether the gauze covering the wound oozes a lot of blood. If there are any of the above conditions, or if there is any other discomfort, you should inform the doctor in time.

Usually the stitches can be removed in about 7 days after the operation, just go to the clinic at the time according to the doctor’s instruction to remove the stitches.

Surgery will produce trauma, try to avoid trauma water, so as not to cause infection, usually after 14 days can be appropriate scrubbing, but do not scrub hard.

After 1~2 days after surgery, the intestines start to move, and diet can be given after anal exhaustion. If the patient still can’t have oral diet or receive enteral nutrition for more than 5 days after surgery, it is necessary to give nutrition in parenteral way, and regular postoperative rehydration may not be able to meet the nutritional needs in this period.

The postoperative diet should start with a fat-free fluid diet and gradually progress to a low-fat regular diet, depending on the patient’s tolerance level. Small, frequent meals should be given, and the daily routine should be based on high-protein, low-calorie, easy-to-digest fluids.

For 3 months after surgery, the patient should maintain a “small, frequent, low-fat diet”. You should not eat too much food containing animal fat at one time, such as animal offal, butter, fatty meat, fried food, etc.

Normal diet can be resumed after 3 months of surgery, but it is still necessary to pay attention to reduce the intake of high-fat, high-cholesterol food, such as animal offal, fried food, cream products, fatty meat, etc.; also try to avoid spicy and stimulating food, such as chili peppers, onions and garlic, etc.; gas-producing food, such as beans and so on, should also be eaten sparingly.

Get out of bed early after surgery, rehabilitation exercises, to avoid intestinal adhesions and limb dysfunction due to prolonged bed rest, plus promote the patient’s gastrointestinal peristalsis, to avoid constipation.

Non-physical workers can resume work after one week, and physical laborers can return to normal life after 2 weeks to 1 month, but they should pay attention to avoiding exertion.

Heavy labor should be avoided for 3 months, especially labor that may cause increased abdominal pressure or abdominal muscle tension, such as carrying heavy objects.

Important note

During an attack of acute cholecystitis, surgery is difficult and risky, and is prone to postoperative complications, so it is not suitable for surgery when you are in pain, and you need to operate after the symptoms have subsided. Please do not consider whether to undergo surgery solely on the basis of pain.

Eating too much greasy food is prone to cholecystitis, especially at the onset of the disease. However, if you are a vegetarian for a long period of time, it will lead to malnutrition, and it is also very likely to cause a decrease in the excretion of bile, so that the bile will be in a state of concentration and stagnation, which will repeatedly stimulate the wall of the gallbladder and cause localized inflammation, and as a result, it will only aggravate the condition of cholecystitis.

Chinese medicine treatment

Chinese medicine believes that the treatment of acute cholecystitis is mainly to clear heat and relieve dampness, move qi and bile, and pass the internal organs and diarrhea; chronic cholecystitis is mainly to dispel the evil spirits.

According to the diagnosis and treatment, we can choose Da Chai Hu Tang, Yin Chen Artemisia Tang and Huang Lian Xie Du Tang; Chai Hu Shu Hepatitis Dispersion, Long Dan Diarrhea Hepatitis Tang and other prescriptions for treatment. However, they should be carried out under the guidance of doctors and should not be used blindly. It can also be combined with other therapies of Chinese medicine, such as acupuncture, auricular acupuncture points, and medicinal plasters.

Prognosis

Cure

The outcome after treatment of cholecystitis is related to the time of starting the treatment and the presence of complications.

Early detection of the disease and treatment is associated with a better therapeutic outcome.

The prognosis is worse if serious complications such as gangrene of the gallbladder and perforation of the gallbladder occur.

Harmfulness

Acute cholecystitis left untreated can lead to gangrene of the gallbladder, perforation of the gallbladder or infectious shock, which in severe cases can lead to death.

Chronic cholecystitis, if left untreated, will recur, affecting diet and rest.

A few patients can induce gallbladder cancer.

Daily

Daily Management

Dietary management

The following diet should be followed during remission.

Low-fat diet: reduce the intake of animal fats such as fatty meat and animal fats. Increase the proportion of vegetable oil intake such as corn oil, sunflower oil, peanut oil and soybean oil in moderation.

High protein diet: choose eggs, fish, lean meat, dairy, soy products and other high-quality protein foods.

Low cholesterol diet: eat less fish roe, animal liver, animal kidney, brain and other foods.

High-vitamin diet: eat more fresh vegetables, fruits and foods such as yogurt, hawthorn and brown rice to supplement vitamins and moderate amount of fiber.

Moderate supplementation of carbohydrates: it can reduce the stimulation of the gallbladder and help maintain liver function, but be careful not to overdo it.

Avoid eating spicy and stimulating foods such as chili, curry, mustard, garlic and stimulating condiments.

Avoid alcohol and coffee, strong tea.

Regular diet, small meals, usually should ensure a balanced diet, avoid eating too full.

Pay attention to dietary hygiene to prevent intestinal parasites and bacterial infections.

Life management

Pay attention to the combination of work and rest, appropriate cold and temperature, quit smoking, and keep a good mood.

Patients who have already suffered from acute and chronic cholecystitis should be actively treated and take medication on time to prevent recurrence.

Regular work and rest, prevent overwork, ensure sufficient sleep, avoid excessive tension, and maintain a relaxed mood.

Exercise management

You can choose suitable exercise methods in your life, such as swimming, jogging, etc., which can help to enhance your physical fitness and improve your body’s resistance to diseases.

Follow-up review

For non-surgical treatment or cholecystostomy, take anti-inflammatory and choleretic drugs as prescribed by the doctor; follow up on time to determine whether cholecystectomy is needed.

Consult the doctor promptly if abdominal pain, fever and jaundice occur.

Prevention

A good lifestyle can help prevent cholecystitis. Regular medical checkups can detect chronic cholecystitis and gallstones as early as possible.

Eat regularly, avoid overeating, and eat a light diet; eat less greasy food, more fresh fruits and vegetables, and drink more water.

Pay attention to hygiene to prevent intestinal parasites and bacterial infections.

Strengthen physical exercise, avoid sedentary behavior, and enhance physical fitness.

Maintain good living habits, quit smoking and drinking, regular work and rest without staying up late.

Healthy slimming, slow weight loss: Be careful not to let your weight drop too quickly, as this will increase the risk of gallstone disease. Set your weight loss goal at 0.5 to 1.0 kilograms a week.