Chronic cholecystitis

Most of the time, chronic cholecystitis is 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. It is more common after age 40. Birth control pills and pregnancy are factors that increase the risk for gallstones.

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

Symptoms of acute cholecystitis can include:

• Sharp, cramping, or dull pain in upper right or upper middle of your belly
• Steady pain lasting about 30 minutes
• Pain that spreads to your back or below your right shoulder blade
• Clay-colored stools
• Fever
• Nausea and vomiting
• Yellowing of skin and whites of the eyes (jaundice)

Your health care provider may order the following blood tests:

• Lipase in order to diagnose diseases of the pancreas
• Complete blood count (CBC)
• Liver function tests in order to evaluate how well the liver is working

Tests that reveal gallstones or inflammation in the gallbladder include:

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

Surgery is the most common treatment. Surgery to remove the gallbladder is called cholecystectomy.

• Laparoscopic cholecystectomy is most often done. This surgery uses smaller surgical cuts, which results in a faster recovery. Many people are able to go 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.

If you are too ill to have surgery because of other diseases or conditions, the gallstones may be dissolved with medicine you take by mouth. However, this may take 2 years or longer to work. The stones may return after treatment.

Cholecystectomy is a common procedure with a low risk.

Complications may include:

• Cancer of the gallbladder (rarely). Sometimes cancer is found in a gallbladder that has been removed.
• Jaundice.
• Pancreatitis.
• Worsening of the condition.

Contact your provider if you develop symptoms of cholecystitis.

The condition is not always preventable. Eating less fatty foods may relieve symptoms in people. However, the benefit of a low-fat diet has not been proven.

Cholecystitis - chronic

Basturk O, Adsay NV. Diseases of the gallbladder. In: Burt AD, Ferrell LD, Hubscher SG, eds. MacSween's Pathology of the Liver. 8th ed. Philadelphia, PA: Elsevier; 2024:chap 10.

Gill RM, Kakar S. Liver and gallbladder. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 65.

Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.