Acute Cholecystitis

In the OR

The objective is not merely gallbladder removal—it is safe biliary anatomy.

Assess inflammation, hydrops, gangrene, perforation and surrounding contamination
Expose the hepatocystic triangle and obtain a safe critical view before division of structures
Use intraoperative cholangiography or another imaging strategy when ductal anatomy or choledocholithiasis is uncertain
When anatomy remains unsafe, use an appropriate bailout strategy rather than persisting with hazardous dissection
Recognize suspected bile duct injury early and obtain hepatobiliary expertise when needed

After the OR

Uncomplicated cases often recover rapidly after laparoscopic cholecystectomy.
Review liver tests and symptoms if retained common bile duct stone is suspected.
Escalate promptly for bile leak, jaundice, sepsis or concern for bile duct injury.
Tailor antimicrobial duration to disease severity and adequacy of source control rather than using a fixed prolonged course for every patient.