Cholecystitis (synonyms: cholecystitis; gallbladder empyema; porcelain gallbladder; ICD-10-GM K81.-: Cholecystitis) is an inflammation of the gallbladder. This is caused in up to 90% of cases by cholelithiasis (gallstone disease). In up to 10% of cases, however, no gallstone can be detected as the cause of cholecystitis.
In up to 85% of cases, bacteria are found in the gallbladder in cholecystitis. In the remaining cases, it is assumed to be a so-called abacterial form, which is caused by mechanical and chemical irritations.
The following forms of cholecystitis are distinguished on the basis of bacterial colonization:
- Ascending cholecystitis – inflammation caused by bacteria ascending from the intestine.
- Descending cholecystitis – inflammation caused by germs descending from the liver.
- Hematogenous cholecystitis – inflammation caused by germs coming from the bloodstream.
- Lymphogenic cholecystitis – inflammation that has occurred through the lymphatic pathway.
Furthermore, cholecystitis can be divided into:
- Acute cholecystitis – sudden inflammation of the gallbladder.
- Chronic cholecystitis – usually low-symptom cholecystitis over a long period of time.
- Emphysematous cholecystitis – form of cholecystitis in which air in the gallbladder can be detected by diagnostic methods.
Sex ratio: men to women is 1: 3, which is due to the fact that women have gallstones more often.
Frequency peak: the disease occurs mainly between the 45th and 70th year of life. Cholecystitis without gallstones is often found in older men.
The prevalence (disease incidence) in the 45- to 70-year-old age group is 10% in men and 20% in women (in Germany).
Course and prognosis: Cholecystitis is often associated with colicky pain, which occurs preferentially after high-fat meals. The course of the disease depends on the cause. If cholecystitis is recognized in time and adequately treated, it usually heals without complications. The German ACDC study provides convincing arguments for laparoscopic cholecystectomy for acute cholecystitis within 24 hours. If cholecystitis is recognized too late, perforation may occur (gallbladder rupture). In chronic cholecystitis, cholecystectomy (surgical removal of the gallbladder) is usually required. Cholecystectomy is among the most commonly performed procedures in surgery.
