Surgical treatment of cholecystitis: indications for surgical intervention

Gallstone disease is one of the most common pathologies of the digestive system. According to various estimates, 10–15% of the adult population has gallstones, and some of them sooner or later develop cholecystitis. When the inflammation becomes regular or complicated, surgeons Helios Medical Center Laparoscopic cholecystectomy is performed - a minimally invasive removal of the gallbladder, which is today considered the gold standard of treatment.

When is gallbladder removal surgery necessary?

Gallstone disease may not manifest itself for a long time and may not require immediate intervention. However, with the appearance of symptoms or complications, conservative treatment usually does not eliminate the cause of the problem. In such cases, cholecystectomy is considered - an operation to remove the gallbladder. The indications for it are determined by the doctor after an examination, and most often these are:

• Acute cholecystitis is an acute inflammation of the gallbladder that often requires surgical treatment.
• Gallstone disease with symptoms of biliary colic, which are recurrent and significantly reduce the quality of life.
• Chronic cholecystitis is a long-term inflammation with thickening of the wall and impaired bladder function.
• Gallbladder polyps of a certain size and growth rate are an indication for surgery due to the risk of malignancy (malignant transformation).
• Gallstone pancreatitis - if stones have caused inflammation of the pancreas.
• Gallbladder dyskinesia is a violation of contractile function in the absence of stones, but with pronounced symptoms.
• Suspected gallbladder cancer - in such cases, open surgery is preferred.

The list is not exhaustive: decisions are always made individually, taking into account the clinical picture and the results of ultrasound, tests, and, if necessary, CT scan.

Why did laparoscopy replace open surgery?

The first laparoscopic cholecystectomy was performed in 1985, and within a few decades this method became the dominant one worldwide. Today, up to 90% of gallbladder removal surgeries are performed laparoscopically. The reason is simple: three small punctures instead of a 10–15 cm incision mean significantly less pain after the operation, a shorter hospital stay and a faster return to normal life.

Medical fact: With laparoscopic cholecystectomy, the frequency of wound infectious complications is significantly lower than with open surgery, and the average hospital discharge time is 1–2 days versus 4–7 with the traditional approach.

At the same time, laparoscopy is not suitable in all cases. In case of gangrenous cholecystitis, severe adhesions or suspected cancer, the surgeon may decide in favor of open surgery or proceed to it during laparoscopy. But at the Helios Medical Center, 99% of operations are performed laparoscopically.

Timing of surgery for cholecystitis: why it is important not to postpone surgery

One of the most interesting findings of modern research concerns the timing of surgery. The American College of Surgeons confirmed in 2024 that early laparoscopic cholecystectomy for acute cholecystitis (within 48 hours) reduces the total length of hospitalization, reduces the risk of complications, and helps the patient return to work more quickly compared to delayed surgery.

In chronic cholecystitis, postponing surgery can also complicate treatment. Each new episode of inflammation contributes to the formation of adhesions around the gallbladder, which makes surgery more technically difficult and increases the risk of conversion to open surgery.

What is important to know before surgery?

Standard preoperative preparation includes blood tests, abdominal ultrasound, electrocardiogram, and consultation with an anesthesiologist. After laparoscopic cholecystectomy, most patients leave the hospital the next day, and return to normal physical activity is usually possible within 1–2 weeks.

Qualified surgeons of the Helios Medical Center perform both planned and emergency interventions in accordance with modern treatment protocols, with 24-hour inpatient supervision during the recovery period.