Skip to main content
WoMWeb of Medicine
SearchGraphHistory
General Surgery›Condition·Updated Jul 11, 2026·v1

Acute Cholecystitis

Acute cholecystitis is a common surgical emergency caused by gallstone-induced cystic duct obstruction, leading to chemical inflammation and secondary bacterial invasion. The Tokyo Guidelines 2018 severity grading (I-III) guides initial management: early laparoscopic cholecystectomy is the definitive treatment for all grades, ideally within 72 hours of symptom onset. Antibiotics are indicated only for moderate-to-severe disease; mild disease can be managed without them. The 'lethal triad' of acute cholecystitis, obesity, and steatohepatitis markedly increases bile duct injury risk, necessitating a low threshold for bailout subtotal cholecystectomy. Special populations, pregnancy, elderly, immunocompromised, require tailored approaches, but early surgery consistently improves outcomes. Percutaneous cholecystostomy is reserved for patients unfit for surgery, with interval cholecystectomy planned at 4-8 weeks. Overall, early laparoscopic cholecystectomy reduces morbidity, hospital stay, and costs, and is the standard of care.

High Evidence299 references·2,938 words·12 min read·v1
acute cholecystitisgallstoneslaparoscopic cholecystectomyTokyo Guidelinesbiliary surgerybile duct injurysubtotal cholecystectomypercutaneous cholecystostomypregnancyelderlyCOVID-19

Quick Reference

RxDrug of choiceFor moderate-to-severe acute cholecystitis: piperacillin-tazobactam 4.5 g IV q6h or ceftriaxone 2 g IV q24h plus metronidazole 500 mg IV q8h. For mild disease, antibiotics may be omitted per recent meta-analyses.
AltAlternativesCefazolin 1 g IV q8h (for mild-moderate); carbapenems (e.g., ertapenem 1 g IV q24h) for severe disease or high-risk patients; fluoroquinolones (e.g., levofloxacin 750 mg IV q24h) plus metronidazole if beta-lactam allergy.
⊘AvoidRoutine extended postoperative antibiotics in mild-to-moderate cholecystitis; non-dihydropyridine calcium channel blockers (diltiazem, verapamil) are not directly contraindicated but have no role; avoid persisting with laparoscopic dissection when critical view of safety cannot be achieved.
DxTest of choiceRight upper quadrant ultrasound (sensitivity 71%, specificity 85%) is the first-line imaging modality. If equivocal or complicated disease suspected, contrast-enhanced CT is preferred.
ScKey scoreTokyo Guidelines 2018 (TG18) severity grade (I-III) dictates initial management: Grade I → early cholecystectomy without antibiotics; Grade II → early cholecystectomy with antibiotics; Grade III → organ support then cholecystectomy. The AAST intraoperative grade (I-V) better predicts mortality and complications.
→When to referAll patients with suspected acute cholecystitis should be referred to a surgeon for consideration of early laparoscopic cholecystectomy. Refer to hepatobiliary specialist if bile duct injury is suspected or for complex biliary reconstructions. Refer to interventional radiology for percutaneous cholecystostomy if patient is not a surgical candidate.
Early laparoscopic cholecystectomy within 72 hours of symptom onset is the definitive treatment for acute cholecystitis. Antibiotics are indicated only for moderate-to-severe disease (Tokyo Grade II/III). In mild disease, antibiotics may be omitted. The Tokyo Guidelines 2018 severity grade guides the need for organ support, antibiotic choice, and urgency of source control. The 'lethal triad' of acute cholecystitis, obesity, and steatohepatitis increases bile duct injury risk 16-fold, mandating a low threshold for bailout subtotal cholecystectomy.
Acute cholecystitis (AC) is a common surgical emergency characterized by gallbladder inflammation, usually due to cystic duct obstruction by gallstones. Prompt diagnosis using Tokyo Guidelines criteria and early laparoscopic cholecystectomy improves outcomes. This concise reference summarizes key clinical facts, risk factors, diagnostic workup, management strategies, and complications for bedside use.

Overview and Recommendations

Background

  • •Acute cholecystitis (AC) is an acute inflammation of the gallbladder, triggered in >90% of cases by cystic duct obstruction from a gallstone. The condition accounts for a substantial proportion of emergency surgical admissions worldwide, with an estimated 1-4% of people with gallstones developing AC annually. Untreated, it progresses to gangrene in up to 20% of cases, with perforation and sepsis carrying a mortality of 8%.
  • •Pathophysiology begins with a chemical injury: the impacted stone blocks bile outflow, raising intraluminal pressure and causing mucosal ischemia. Bile salts and phospholipase A2 generate lysolecithin, a detergent that disrupts the epithelial barrier. This is followed by a neutrophilic infiltrate and, later, secondary bacterial invasion, detected by PCR in 50% of bile samples despite only 19% positive by culture. The most common isolates are Escherichia coli, Klebsiella species, and Enterococcus.
  • •The Tokyo Guidelines 2018 (TG18) classify AC into three severity grades: Grade I (mild, no organ dysfunction), Grade II (moderate, marked local inflammation with WBC >18,000/μL, palpable mass, or duration >72 h), and Grade III (severe, with organ dysfunction including hypotension, respiratory failure, or DIC). The 2018 revision removed the previous 72-hour time limit for early cholecystectomy, expanding surgery to all grades within 7 days of symptom onset. The AAST intraoperative severity grading (I-V) outperforms TG18 for predicting mortality and complications.
  • •Key risk factors for AC include gallstones, obesity, metabolic syndrome, rapid weight loss, and sickle cell disease. The 'lethal triad' of acute cholecystitis, obesity (BMI ≥30), and steatohepatitis increases the risk of bile duct injury by 16-fold (OR 16.35). COVID-19 infection independently doubles the incidence of gangrenous cholecystitis (40.7% vs 22.3%) and raises mortality to 13.4% (OR 5.0). The ACME score identifies four independent mortality risk factors: COPD, dementia, age >80 years, and need for preoperative vasoactive amines (AUROC 0.88).

Evaluation

  • •Suspect acute cholecystitis in any patient presenting with acute right upper quadrant (RUQ) or epigastric pain, often radiating to the right shoulder or interscapular region, with nausea and vomiting. Fever is present in about one-third at presentation but develops in most within 24 hours. An antecedent history of biliary colic (postprandial pain lasting 30-90 minutes) is elicited in 60-80% of patients.
  • •Examine for Murphy sign, the most specific physical finding: the patient arrests inspiration when the examiner’s fingers press beneath the right costal margin during deep breath. Sensitivity ranges 65-97%, specificity 87-96%. Guarding or rebound tenderness suggests gangrenous or perforated cholecystitis. A palpable gallbladder (Courvoisier sign) is uncommon and should raise suspicion for gallbladder carcinoma or choledocholithiasis.
  • •Red flags for severe disease include systemic inflammatory response syndrome (SIRS) or sepsis, rebound tenderness or generalized peritonitis, jaundice (indicating choledocholithiasis or Mirizzi syndrome), and upper gastrointestinal bleeding (possible cystic artery pseudoaneurysm). In elderly, diabetic, or immunocompromised patients, atypical presentations with minimal pain or fever are common, a high index of suspicion and low-threshold imaging are essential.
  • •Order laboratory studies: complete blood count with differential, C-reactive protein (CRP), liver function tests (LFTs) including γ-glutamyl transferase (GGT), and lipase. A neutrophil count is an independent predictor of AC. The neutrophil-to-lymphocyte ratio (NLR) has high diagnostic accuracy (pooled DOR 2.257), but CRP is superior for assessing severity per Tokyo Guidelines. A GGT >224 IU/L has 80.6% sensitivity and 75.3% specificity for predicting coexisting common bile duct stones.
  • •Use the Tokyo Guidelines 2018 (TG18) diagnostic criteria: a definitive diagnosis requires one item from each of three axes, A) local signs (Murphy sign, RUQ mass/pain/tenderness), B) systemic signs (fever >37.5°C, elevated CRP, elevated WBC), and C) imaging findings (gallbladder wall thickening >4 mm, distention >8 cm long axis, pericholecystic fluid, sonographic Murphy sign). The TG18 criteria have 83.1% sensitivity but 37.5% specificity, so clinical judgment is essential.
  • •First-line imaging is RUQ ultrasound. Pooled sensitivity is 71% (95% CI 69-72%) and specificity 85% (95% CI 84-86%). Key sonographic findings include gallbladder wall thickening >4 mm, pericholecystic fluid, gallbladder distention, gallstones, and a sonographic Murphy sign. Surgeon-performed US has comparable diagnostic performance to radiologist-performed US (sensitivity 60% vs 80%, specificity 98.6% vs 97.8%). A cystic artery velocity cutoff ≥42.6 cm/s has a PPV of 77.3% for AC.
  • •If ultrasound is equivocal or complicated cholecystitis is suspected (e.g., severe pain, CRP >150 mg/L, suspicion of gangrene or emphysema), obtain contrast-enhanced CT. CT has lower sensitivity than US for AC (52.3% vs 79.4%) but higher specificity (92.3% vs 61.5%) and better detects complications like gangrenous, emphysematous, or perforated cholecystitis. If choledocholithiasis is suspected (elevated GGT, bilirubin, dilated CBD), order MRCP or ERCP.
  • •Consider alternative diagnoses: biliary colic (no systemic signs, normal imaging except gallstones), choledocholithiasis (jaundice, dilated CBD, abnormal LFTs), acute cholangitis (Charcot’s triad: fever, jaundice, RUQ pain), acute pancreatitis (epigastric pain radiating to back, elevated lipase), perforated peptic ulcer (peritonitis, free air on upright CXR), hepatitis (transaminitis, viral serology), right lower lobe pneumonia (respiratory symptoms, chest X-ray findings), Fitz-Hugh-Curtis syndrome (perihepatitis from PID), and gallbladder cancer (focal wall thickening, intraluminal mass, enlarged lymph nodes).
  • •Severity grade the patient using TG18: Grade I (mild) = no organ dysfunction, WBC ≤18,000/μL, CRP <10 mg/dL, no gallbladder necrosis or abscess; Grade II (moderate) = any of WBC >18,000/μL, palpable tender mass, duration >72 h, marked wall thickening, gangrenous changes; Grade III (severe) = organ dysfunction (hypotension, altered consciousness, respiratory failure, renal failure, DIC). This grade directly dictates initial management and urgency of source control.

Management

  • •Begin with initial resuscitation: intravenous crystalloid (balanced solution preferred), nil per os, and multimodal analgesia (e.g., NSAIDs with or without opioids). For Grade III (severe) cholecystitis or sepsis, admit to ICU and start early vasopressor support (norepinephrine) if MAP remains <65 mmHg after fluid resuscitation. COVID-19 infection warrants escalated monitoring for rapid progression to gangrenous cholecystitis.
  • •Administer antibiotics only for Grade II (moderate) and Grade III (severe) cholecystitis. For Grade I (mild), three meta-analyses and a large RCT (Park et al., N=370) show no benefit: postoperative infection rates 7.6% with antibiotics vs 7.0% with placebo (P=0.842). Therefore, antibiotics may be omitted in mild disease in otherwise healthy patients. For Grade II, use cefazolin 1 g IV q8h or a second-generation cephalosporin (e.g., cefoxitin 2 g IV q6h). For Grade III or septic shock, use piperacillin-tazobactam 4.5 g IV q6h or ceftriaxone 2 g IV q24h plus metronidazole 500 mg IV q8h.
  • •Postoperative antibiotics: for mild-to-moderate cholecystitis after adequate source control, antibiotics beyond 24 hours do not improve outcomes. After percutaneous cholecystostomy, antibiotics can be safely discontinued within 7 days. For severe disease, duration is guided by clinical response, typically 4-7 days. Blood and bile cultures, when obtained, guide de-escalation.
  • •Definitive source control is early laparoscopic cholecystectomy (LC). Perform LC within 72 hours of symptom onset, this window significantly reduces postoperative complications (RR 0.60, 95% CI 0.39-0.92). The ACDC trial (N=618) showed morbidity 11.8% with early surgery vs 34.4% with delayed surgery, shorter hospital stay (5.4 vs 10.0 days), and lower costs. Surgery within 48 hours of admission yields the best outcomes; delaying beyond 2 days increases mortality, complications, and cost incrementally.
  • •For Grade I and II cholecystitis, proceed directly to early laparoscopic cholecystectomy during the index admission. For Grade III, provide organ support (ICU, vasopressors, antibiotics) first, then perform surgery once organ dysfunction resolves, typically within 24-48 hours. The TG18 2018 revision removed the rigid 72-hour cutoff, allowing safe early cholecystectomy for all grades within 7 days of symptom onset.
  • •Intraoperatively, achieve the critical view of safety (CVS) before dividing any structures. If CVS cannot be obtained due to dense inflammation, perform a bailout procedure: subtotal cholecystectomy (STC) is preferred over conversion to open surgery. STC carries a very low bile duct injury (BDI) rate of 0.3% but a bile leak rate of 13.5%. Reconstituting STC (stump closure) yields fewer bile leaks than fenestrating STC. Conversion to open cholecystectomy carries the highest BDI rate (4.4% at 1 year).
  • •For patients who are not operative candidates (e.g., Tokyo III with severe comorbidities, cancer, frailty), consider percutaneous cholecystostomy (PC) or endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with a lumen-apposing metal stent. PC achieves sepsis resolution in 81.7% within 72 hours but carries 30-day mortality of 7.8% and 1-year mortality of 25.2%. After PC, perform interval cholecystectomy at 4-8 weeks (early ≤1 month reduces complications, but delayed ≥8 weeks may improve discharge home).
  • •Antibiotic prophylaxis: for mild-to-moderate disease, a single preoperative dose of a broad-spectrum antibiotic (e.g., cefazolin 2000 mg) is sufficient. Extended postoperative antibiotics do not reduce surgical site infections (4% vs 4% with extended therapy, absolute difference 0.2%). Routine extended prophylaxis is not indicated.
  • •Special populations: In pregnancy, perform laparoscopic cholecystectomy regardless of trimester, it reduces adverse pregnancy outcomes (OR 0.60, 95% CI 0.42-0.87) and each day of delay increases fetal complications (OR 1.173, P<0.001). In elderly patients ≥80 years, early cholecystectomy reduces 1-year mortality (20.8% vs 27.1% with conservative management) despite higher 30-day mortality; laparoscopic approach is critical (84% relative risk reduction in 30-day mortality vs open). In immunocompromised patients (cancer, transplant), consider EUS-GBD as alternative to PC; in heart transplant recipients, cholecystectomy carries inpatient mortality 2.2% (higher if open or urgent).
  • •Monitor for resolution of SIRS criteria: temperature, heart rate, respiratory rate, WBC. If no improvement within 48 hours, reassess for inadequate source control (e.g., gangrenous cholecystitis, perforation, resistant organisms). For patients with PC, perform a check cholangiogram to detect common bile duct stones (present in 28.1%). After ERCP clearance of CBD stones, perform same-admission cholecystectomy within 7 days to prevent recurrent acute cholecystitis (risk of biliary events reaches 2.5% by 7 days and 53.3% at 1 year).
  • •Avoid routine intraoperative cholangiography solely to prevent BDI, it has not been shown to reduce BDI risk. Avoid non-dihydropyridine CCBs (diltiazem, verapamil) as they may exacerbate gallbladder stasis? Not directly relevant; avoid persisting with laparoscopic dissection when CVS cannot be achieved. Avoid extended postoperative antibiotics in mild-moderate disease. Refer to a hepatobiliary surgeon if BDI is suspected or for complex biliary reconstructions.

Board Review — High Yield

  • •Tokyo Guidelines 2018 severity grade, Grade I (mild): no organ dysfunction, WBC ≤18,000/μL, CRP <10 mg/dL; Grade II (moderate): WBC >18,000/μL, palpable mass, duration >72 h, or gangrenous changes; Grade III (severe): organ dysfunction (hypotension, respiratory failure, DIC). Grade directs management.
  • •Lethal triad, Acute cholecystitis + obesity (BMI ≥30) + steatohepatitis increases bile duct injury risk 16-fold (OR 16.35).
  • •ACDC trial, Early laparoscopic cholecystectomy (within 24 h of admission) vs delayed (7-45 days): morbidity 11.8% vs 34.4%, hospital stay 5.4 vs 10.0 days, costs lower. NNT to prevent one morbidity = 5.
  • •Bailout procedure, When critical view of safety cannot be achieved, subtotal cholecystectomy (STC) is preferred over conversion. STC BDI rate 0.3%, bile leak 13.5%. Reconstituting STC (closed stump) reduces bile leaks vs fenestrating.
  • •Antibiotics in mild disease, Multiple RCTs and meta-analyses show no benefit of antibiotics in Tokyo I cholecystitis. Single-dose prophylaxis is sufficient; extended antibiotics do not reduce infectious complications.
  • •Timing from symptom onset, Surgery within 72 hours of symptom onset reduces postoperative complications (RR 0.60). Surgery within 48 hours of admission yields best outcomes and lowest costs.
  • •Pregnancy, Laparoscopic cholecystectomy reduces adverse pregnancy outcomes (OR 0.60) regardless of trimester. Each day of delay increases fetal complications (OR 1.173). SAGES conditionally recommends surgery over nonoperative management.
  • •Gallbladder perforation, Occurs in up to 20% of untreated cases; risk factors: age >65, elevated CRP. Mortality 8%, conversion rate 22%, mean LOS 11.2 days. Most perforated cases have advanced inflammation (gangrene/empyema) on histology.
  • •Recurrence after conservative management, 22% of patients managed nonoperatively develop recurrent biliary events. After ERCP clearance of CBD stones, same-admission cholecystectomy within 7 days reduces recurrent AC (risk reaches 2.5% by 7 days, 53.3% at 1 year).
  • •COVID-19 and AC, COVID-19 infection independently doubles gangrenous cholecystitis incidence (40.7% vs 22.3%) and increases mortality 5-fold (OR 5.0). These patients warrant escalated monitoring and early source control.

Deep Dive — Evidence Details

References

  1. [1]

    Toro A, Teodoro M, Khan M et al.. “Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy-a systematic review.” World journal of emergency surgery : WJES (2021). PMID: 34496916 ↗

    L5SR_OBSCited in: Definition, Classification and Surgical Nomenclature, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  2. [2]

    van Baal MC, Besselink MG, Bakker OJ et al.. “Timing of cholecystectomy after mild biliary pancreatitis: a systematic review.” Annals of surgery (2012). PMID: 22470079 ↗

    L2SR_OBSCited in: Definition, Classification and Surgical Nomenclature, Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History
  3. [3]

    Borzellino G, Khuri S, Pisano M et al.. “Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis revised: Protocol of a systematic review and meta-analysis of results.” World journal of emergency surgery : WJES (2020). PMID: 31911813 ↗

    L5SR_OBSCited in: Definition, Classification and Surgical Nomenclature, Complications and Their Management
  4. [4]

    Cheo FY, Sin EI. “Outcomes of Early Compared to Late Interval Cholecystectomy Post-Percutaneous Cholecystostomy in Patients Diagnosed With Acute Cholecystitis: A Systematic Review and Meta-Analysis.” World journal of surgery (2026). PMID: 42012770 ↗

    L1SR_OBSCited in: Definition, Classification and Surgical Nomenclature, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  5. [5]

    Terho PM, Leppäniemi AK, Mentula PJ. “Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications.” World journal of emergency surgery : WJES (2016). PMID: 27891173 ↗

    L3COHORTCited in: Definition, Classification and Surgical Nomenclature, Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Special Populations & Pregnancy
  6. [6]

    Eikermann M, Siegel R, Broeders I et al.. “Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES).” Surgical endoscopy (2012). PMID: 23052493 ↗

    L1GUIDELINECited in: Definition, Classification and Surgical Nomenclature, History and Evolution of Treatment
  7. [7]

    Joseph M, Phillips MR, Farrell TM et al.. “Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution.” Annals of surgery (2012). PMID: 22664556 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Surgical Nomenclature, Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  8. [8]

    De Simone B, Abu-Zidan FM, Chouillard E et al.. “The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?” World journal of emergency surgery : WJES (2022). PMID: 36527038 ↗

    L2OTHERCited in: Definition, Classification and Surgical Nomenclature, Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  9. [9]

    González-Castillo AM, Sancho-Insenser J, De Miguel-Palacio M et al.. “Mortality risk estimation in acute calculous cholecystitis: beyond the Tokyo Guidelines.” World journal of emergency surgery : WJES (2021). PMID: 33975601 ↗

    L3OTHERCited in: Definition, Classification and Surgical Nomenclature, Epidemiology, Etiology and Risk Factors, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  10. [10]

    Malvaux P, Gherardi D, Gryspeerdt F et al.. “The utility of the CADISS® system in laparoscopic cholecystectomy for acute cholecystitis.” Surgical endoscopy (2022). PMID: 36319896 ↗

    L4TRIAL_NONRANDOMCited in: Definition, Classification and Surgical Nomenclature, Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors
  11. [11]

    Cirocchi R, Amato L, Ungania S et al.. “Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy-Systematic Review and Meta-Analysis.” Journal of clinical medicine (2023). PMID: 37568306 ↗

    L2SR_OBSCited in: Definition, Classification and Surgical Nomenclature
  12. [12]

    Al-Ali KOH, Kurkoosh HYN, Mohaibes M et al.. “Predictors and reasons for conversion of laparoscopic to open cholecystectomy: a five-year cohort study.” Surgical endoscopy (2026). PMID: 42295406 ↗

    L3COHORTCited in: Definition, Classification and Surgical Nomenclature
  13. [13]

    Lin D, Wu S, Fan Y et al.. “Comparison of laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy in aged acute calculous cholecystitis: a cohort study.” Surgical endoscopy (2019). PMID: 31463722 ↗

    L3COHORTCited in: Definition, Classification and Surgical Nomenclature
  14. [14]

    Zafar SN, Obirieze A, Adesibikan B et al.. “Optimal time for early laparoscopic cholecystectomy for acute cholecystitis.” JAMA surgery (2015). PMID: 25517723 ↗

    L3OTHERCited in: Definition, Classification and Surgical Nomenclature, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Special Populations & Pregnancy
  15. [15]

    Leppäniemi A, Jousela I. “A traffic-light coding system to organize emergency surgery across surgical disciplines.” The British journal of surgery (2013). PMID: 24272758 ↗

    L4OTHERCited in: Definition, Classification and Surgical Nomenclature
  16. [16]

    Manatakis DK, Papageorgiou D, Antonopoulou MI et al.. “Ten-year Audit of Safe Bail-Out Alternatives to the Critical View of Safety in Laparoscopic Cholecystectomy.” World journal of surgery (2019). PMID: 31312948 ↗

    L4OTHERCited in: Definition, Classification and Surgical Nomenclature, Complications and Their Management
  17. [17]

    Karamanos E, Sivrikoz E, Beale E et al.. “Effect of diabetes on outcomes in patients undergoing emergent cholecystectomy for acute cholecystitis.” World journal of surgery (2013). PMID: 23677561 ↗

    L3OTHERCited in: Definition, Classification and Surgical Nomenclature
  18. [18]

    Vanella G, Guilabert L, Frigo F et al.. “Endoscopic ultrasound-guided gallbladder drainage in acute cholecystitis with contained perforation: a prospective cohort study.” Endoscopy (2026). PMID: 41927018 ↗

    L4TRIAL_NONRANDOMCited in: Definition, Classification and Surgical Nomenclature
  19. [19]

    Lisotti A, Napoleon B, Fabbri C et al.. “Treatment of acute cholecystitis in high-risk surgical patients.” Minerva gastroenterology (2021). PMID: 33793158 ↗

    L2SR_OBSCited in: Definition, Classification and Surgical Nomenclature
  20. [20]

    Pesce A, Fabbri N, Bonazza L et al.. “The role of fluorescent cholangiography to improve operative safety in different severity degrees of acute cholecystitis during emergency laparoscopic cholecystectomy: a prospective cohort study.” International journal of surgery (London, England) (2024). PMID: 39806739 ↗

    L4COHORTCited in: Definition, Classification and Surgical Nomenclature, Severity, Surgical Scoring and Risk Stratification
  21. [21]

    Sabour AF, Matsushima K, Love BE et al.. “Nationwide trends in the use of subtotal cholecystectomy for acute cholecystitis.” Surgery (2019). PMID: 31879089 ↗

    L4OTHERCited in: Definition, Classification and Surgical Nomenclature, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  22. [22]

    Gwinn EC, Daly S, Deziel DJ. “The use of laparoscopic ultrasound in difficult cholecystectomy cases significantly decreases morbidity.” Surgery (2013). PMID: 24074430 ↗

    L2OTHERCited in: Definition, Classification and Surgical Nomenclature, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization
  23. [23]

    Kortram K, de Vries Reilingh TS, Wiezer MJ et al.. “Percutaneous drainage for acute calculous cholecystitis.” Surgical endoscopy (2011). PMID: 21638173 ↗

    L5OTHERCited in: Definition, Classification and Surgical Nomenclature, Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Complications and Their Management, Special Populations & Pregnancy
  24. [24]

    Mishima K, Fujiyama Y, Wakabayashi T et al.. “Early laparoscopic cholecystectomy for acute cholecystitis following the Tokyo Guidelines 2018: a prospective single-center study of 201 consecutive cases.” Surgical endoscopy (2023). PMID: 37118031 ↗

    L4OTHERCited in: Definition, Classification and Surgical Nomenclature, Diagnosis and Workup
  25. [25]

    Russell D, Condon F, Cole W et al.. “Intraoperative bile spillage as a risk factor for surgical site infection: a propensity score-matched NSQIP analysis.” Surgical endoscopy (2022). PMID: 34988739 ↗

    L3OTHERCited in: Definition, Classification and Surgical Nomenclature, Complications and Their Management
  26. [26]

    Nassar AHM, Sallam M, Khan KS et al.. “A proposed difficulty grading system for laparoscopic bile duct exploration: benefits to clinical practice, training and research.” Surgical endoscopy (2023). PMID: 37349591 ↗

    L2OTHERCited in: Definition, Classification and Surgical Nomenclature
  27. [27]

    De Simone B, Abu-Zidan FM, Kasongo L et al.. “COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study.” World journal of emergency surgery : WJES (2025). PMID: 40001181 ↗

    L2COHORTCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Prognosis and Natural History, Special Populations & Pregnancy
  28. [28]

    Nagaraja V, Eslick GD, Cox MR. “The acute surgical unit model verses the traditional "on call" model: a systematic review and meta-analysis.” World journal of surgery (2014). PMID: 24430507 ↗

    L1SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  29. [29]

    Habeeb TAAM, Kermansaravi M, Giménez ME et al.. “Sleeve Gastrectomy and Cholecystectomy are Safe in Obese Patients with Asymptomatic Cholelithiasis. A Multicenter Randomized Trial.” World journal of surgery (2022). PMID: 35397750 ↗

    L1RCTCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, History and Evolution of Treatment
  30. [30]

    Chang SK, Wang YL, Shen L et al.. “A randomized controlled trial comparing post-operative pain in single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy.” World journal of surgery (2015). PMID: 25446490 ↗

    L1RCTCited in: Pathophysiology and the Surgical Lesion, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, History and Evolution of Treatment
  31. [31]

    Khan QI, Baig H, Khan M et al.. “The optimal timing of laparoscopic cholecystectomy for acute cholecystitis according to symptom onset and patient admission: a meta-analysis of randomised controlled trials.” Surgical endoscopy (2026). PMID: 42377519 ↗

    L1SR_MA_RCTCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  32. [32]

    Caroli A, Perico N, Perna A et al.. “Effect of longacting somatostatin analogue on kidney and cyst growth in autosomal dominant polycystic kidney disease (ALADIN): a randomised, placebo-controlled, multicentre trial.” Lancet (London, England) (2013). PMID: 23972263 ↗

    L1RCTCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, History and Evolution of Treatment, Prognosis and Natural History
  33. [33]

    Jayakrishnan TT, Groeschl RT, George B et al.. “Management of acute cholecystitis in cancer patients: a comparative effectiveness approach.” Surgical endoscopy (2014). PMID: 24687416 ↗

    L2SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History, Prevention, Screening & Surveillance
  34. [34]

    Borzellino G, Sauerland S, Minicozzi AM et al.. “Laparoscopic cholecystectomy for severe acute cholecystitis. A meta-analysis of results.” Surgical endoscopy (2007). PMID: 17704863 ↗

    L1SR_OBSCited in: Pathophysiology and the Surgical Lesion, Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  35. [35]

    Hemerly MC, de Moura DTH, do Monte Junior ES et al.. “Endoscopic ultrasound (EUS)-guided cholecystostomy versus percutaneous cholecystostomy (PTC) in the management of acute cholecystitis in patients unfit for surgery: a systematic review and meta-analysis.” Surgical endoscopy (2022). PMID: 36289089 ↗

    L1SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup
  36. [36]

    Antoniou SA, Pointner R, Granderath FA. “Single-incision laparoscopic cholecystectomy: a systematic review.” Surgical endoscopy (2010). PMID: 20607556 ↗

    L4SR_OBSCited in: Pathophysiology and the Surgical Lesion, Clinical Presentation and Focused Examination, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  37. [37]

    Ahn KS, Kim YH, Kang KJ et al.. “Impact of Preoperative ERCP on Laparoscopic Cholecystectomy: A Case-Controlled Study with Propensity Score Matching.” World journal of surgery (2015). PMID: 25894408 ↗

    L2CASE_CONTROLCited in: Pathophysiology and the Surgical Lesion, Operative Approach, Technique Selection and Perioperative Optimization
  38. [38]

    Marciniak C, Lenne X, Bruandet A et al.. “Risk-Benefit Balance of Simultaneous Gastric Bypass or Sleeve Gastrectomy and Concomitant Cholecystectomy: A Comprehensive Nationwide Cohort of 289,627 Patients.” Annals of surgery (2023). PMID: 37476980 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Complications and Their Management
  39. [39]

    Kilic A, Sheer A, Shah AS et al.. “Outcomes of cholecystectomy in US heart transplant recipients.” Annals of surgery (2013). PMID: 23478523 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  40. [40]

    de Mestral C, Rotstein OD, Laupacis A et al.. “Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis.” Annals of surgery (2014). PMID: 23979286 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Special Populations & Pregnancy
  41. [41]

    Banz V, Gsponer T, Candinas D et al.. “Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy.” Annals of surgery (2011). PMID: 21817893 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Special Populations & Pregnancy
  42. [42]

    Currò G, Meo A, Ippolito D et al.. “Asymptomatic cholelithiasis in children with sickle cell disease: early or delayed cholecystectomy?” Annals of surgery (2007). PMID: 17197975 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Complications and Their Management
  43. [43]

    von Kroge PH, Duprée A, Mann O et al.. “Abdominal emergency surgery in patients with hematological malignancies: a retrospective single-center analysis.” World journal of emergency surgery : WJES (2023). PMID: 36747231 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  44. [44]

    Jansen S, Stodolski M, Zirngibl H et al.. “Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis.” World journal of emergency surgery : WJES (2018). PMID: 29467816 ↗

    L3OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Special Populations & Pregnancy
  45. [45]

    Campanile FC, Podda M, Arezzo A et al.. “Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement.” World journal of emergency surgery : WJES (2020). PMID: 32513287 ↗

    L5OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  46. [46]

    Mouawad NJ, Crofts B, Streu R et al.. “Acute gallbladder torsion - a continued pre-operative diagnostic dilemma.” World journal of emergency surgery : WJES (2011). PMID: 21489292 ↗

    L4OTHERCited in: Pathophysiology and the Surgical Lesion
  47. [47]

    Toro A, Rapisarda M, Maugeri D et al.. “Acute cholecystitis: how to avoid subtotal cholecystectomy-preliminary results.” World journal of emergency surgery : WJES (2024). PMID: 38281952 ↗

    L4OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  48. [48]

    Edblom M, Enochsson L, Nyström H et al.. “Cholecystectomy for acute cholecystitis during weekend compared with delayed weekday surgery: A nationwide population cohort study.” Surgery (2024). PMID: 39740602 ↗

    L2COHORTCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Special Populations & Pregnancy
  49. [49]

    Nadeem MA, Awan AR, Wehrle CJ et al.. “Operative strategies for the acute difficult gallbladder: a Society for Surgery of the Alimentary Tract state-of-the-art systematic review and meta-analysis of subtotal cholecystectomy outcomes.” Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (2026). PMID: 41644007 ↗

    L1SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  50. [50]

    Smith NJ, Lai SD, Windsor JA et al.. “Completion cholecystectomy: a meta-analysis of indications, techniques and outcomes.” HPB : the official journal of the International Hepato Pancreato Biliary Association (2025). PMID: 41365761 ↗

    L1SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  51. [51]

    Moqbel I, Albashier M, Tawadros MM et al.. “Safety and efficacy of ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: an updated systematic review and meta-analysis.” Surgical endoscopy (2025). PMID: 40897880 ↗

    L2SR_OBSCited in: Pathophysiology and the Surgical Lesion, Complications and Their Management
  52. [52]

    Burns R, Connor KL, Guest RV et al.. “Risk factors and mitigating measures associated with bile duct injury during cholecystectomy: meta-analysis.” BJS open (2025). PMID: 40751483 ↗

    L3SR_OBSCited in: Pathophysiology and the Surgical Lesion, Complications and Their Management
  53. [53]

    Lopimpisuth C, Vedantam S, Danpanichkul P et al.. “Postprocedural cholecystitis following covered self-expandable metal stent placement in patients with distal malignant biliary obstruction: a systematic review and meta-analysis.” Gastrointestinal endoscopy (2025). PMID: 40602730 ↗

    L2SR_OBSCited in: Pathophysiology and the Surgical Lesion
  54. [54]

    Jayakrishnan TT, Groeschl RT, George B et al.. “Review of the impact of antineoplastic therapies on the risk for cholelithiasis and acute cholecystitis.” Annals of surgical oncology (2013). PMID: 24114054 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Prognosis and Natural History
  55. [55]

    McGillicuddy EA, Schuster KM, Barre K et al.. “Non-operative management of acute cholecystitis in the elderly.” The British journal of surgery (2012). PMID: 22829411 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  56. [56]

    Gelbard R, Karamanos E, Teixeira PG et al.. “Effect of delaying same-admission cholecystectomy on outcomes in patients with diabetes.” The British journal of surgery (2013). PMID: 24338895 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  57. [57]

    Lemos R, França PH, Ferreira LE et al.. “Detection of bacterial DNA in acute and chronic cholecystitis.” The British journal of surgery (2010). PMID: 20169571 ↗

    L4OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Special Populations & Pregnancy
  58. [58]

    Tarar ZI, Gandhi M, Farooq U et al.. “Role of Prophylactic Endoscopic Gallbladder Stent Placement for Prevention of Acute Cholecystitis in Patients Receiving Stenting for Malignant Biliary Obstruction: A Meta-Analysis.” Digestive diseases and sciences (2025). PMID: 41188668 ↗

    L2SR_OBSCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors
  59. [59]

    Psaltis E, Zaitoun AM, Neal KR et al.. “Immunohistochemical inflammation in histologically normal gallbladders containing gallstones.” World journal of surgery (2024). PMID: 38777749 ↗

    L3OTHERCited in: Pathophysiology and the Surgical Lesion, Severity, Surgical Scoring and Risk Stratification, Special Populations & Pregnancy
  60. [60]

    Norlén O, Hessman O, Stålberg P et al.. “Prophylactic cholecystectomy in midgut carcinoid patients.” World journal of surgery (2010). PMID: 20130865 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History, Special Populations & Pregnancy
  61. [61]

    Widjaja SP, Fischer H, Brunner AR et al.. “Acceptance of Ambulatory Laparoscopic Cholecystectomy in Central Switzerland.” World journal of surgery (2017). PMID: 28660320 ↗

    L4OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, History and Evolution of Treatment
  62. [62]

    Yang PS, Liu CP, Hsu YC et al.. “A Novel Prediction Model for Bloodstream Infections in Hepatobiliary-Pancreatic Surgery Patients.” World journal of surgery (2019). PMID: 30603763 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  63. [63]

    Naidu K, Beenen E, Gananadha S et al.. “The Yield of Fever, Inflammatory Markers and Ultrasound in the Diagnosis of Acute Cholecystitis: A Validation of the 2013 Tokyo Guidelines.” World journal of surgery (2016). PMID: 27460142 ↗

    L4OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup
  64. [64]

    Csikesz N, Ricciardi R, Tseng JF et al.. “Current status of surgical management of acute cholecystitis in the United States.” World journal of surgery (2008). PMID: 18668287 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management
  65. [65]

    Pesce A, Ramírez-Giraldo C. “Which is the best timing for performing a cholecystectomy after percutaneous cholecystostomy?” Surgical endoscopy (2024). PMID: 39658671 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Complications and Their Management
  66. [66]

    Huy TC, Fitzsimmons K, Park J et al.. “The robotic era: 11-year retrospective study of cholecystectomies at a veterans affairs hospital.” Surgical endoscopy (2025). PMID: 40905966 ↗

    L2COHORTCited in: Pathophysiology and the Surgical Lesion, Complications and Their Management
  67. [67]

    Moreira E, Ojeda J, Silvera P et al.. “Acute Cholecystitis Management in Uruguay: Retrospective Study on Surgical Outcomes and Risk Factors.” The Journal of surgical research (2025). PMID: 40683044 ↗

    L2COHORTCited in: Pathophysiology and the Surgical Lesion, Complications and Their Management
  68. [68]

    Sugiyama A, Dhillon NK, Zakhary B et al.. “Outcomes are equivalent between robotic and laparoscopic cholecystectomy in all grades of acute cholecystitis.” Surgery (2026). PMID: 41936770 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  69. [69]

    Shiihara M, Sudo Y, Matsushita N et al.. “Preoperative difficulty assessment of interval laparoscopic cholecystectomy for gallstones.” Surgery (2024). PMID: 38521628 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  70. [70]

    Johnson PL, Williams JE, Schaefer SL et al.. “Variation in acute cholecystitis outcomes and processes of care in patients with cancer.” Surgery (2024). PMID: 39394020 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  71. [71]

    Zapf MA, Kothari AN, Markossian T et al.. “The "weekend effect" in urgent general operative procedures.” Surgery (2015). PMID: 26013983 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  72. [72]

    Taghavi S, Ambur V, Jayarajan SN et al.. “Postoperative outcomes with cholecystectomy in lung transplant recipients.” Surgery (2015). PMID: 25999250 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History
  73. [73]

    Turcotte J, Leydorf SD, Ali M et al.. “Indocyanine green does not decrease the need for bail-out operation in an acute care surgery population.” Surgery (2020). PMID: 32718803 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  74. [74]

    Neylan CJ, Damrauer SM, Kelz RR et al.. “The role of body mass index class in cholecystectomy after acute cholecystitis: An American College of Surgeons National Surgical Quality Improvement Program analysis.” Surgery (2016). PMID: 27425042 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Clinical Presentation and Focused Examination, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  75. [75]

    Suzuki Y, Yoshida M, Goto A et al.. “Development and validation of a nomogram to predict the need for bailout procedure in laparoscopic cholecystectomy: A multicenter study of 1,898 cases.” Surgery (2025). PMID: 40101335 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  76. [76]

    Maurer LR, Maatman TK, Luckhurst CM et al.. “Risk of gallstone-related complications in necrotizing pancreatitis patients treated with a step-up approach: The experience of two tertiary care centers.” Surgery (2020). PMID: 33323200 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Complications and Their Management
  77. [77]

    Jariwalla NR, Khan AH, Dua K et al.. “Management of Acute Cholecystitis during Neoadjuvant Therapy in Patients with Pancreatic Adenocarcinoma.” Annals of surgical oncology (2019). PMID: 31641946 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Special Populations & Pregnancy
  78. [78]

    Su Y, Gao W, Yuan C et al.. “Acute cholecystitis complicated with hepatic abscess caused by rare heterogeneous mucoid Salmonella Enteritidis: case report and literature review.” World journal of microbiology & biotechnology (2026). PMID: 41830993 ↗

    L4CASE_REPORTCited in: Pathophysiology and the Surgical Lesion, History and Evolution of Treatment
  79. [79]

    D'Acapito F, Cucchetti A, Di Pietrantonio D et al.. “Forecasting outcomes after cholecystectomy in octogenarian patients.” Surgical endoscopy (2021). PMID: 34697679 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Special Populations & Pregnancy
  80. [80]

    Gutierrez JV, Chen DG, Yheulon CG et al.. “Acute cholecystitis, obesity, and steatohepatitis constitute the lethal triad for bile duct injury (BDI) during laparoscopic cholecystectomy.” Surgical endoscopy (2024). PMID: 38459210 ↗

    L2OTHERCited in: Pathophysiology and the Surgical Lesion, Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Complications and Their Management, Special Populations & Pregnancy
  81. [81]

    Pisano M, Allievi N, Gurusamy K et al.. “2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis.” World journal of emergency surgery : WJES (2020). PMID: 33153472 ↗

    L1GUIDELINECited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, History and Evolution of Treatment
  82. [82]

    Lau H, Lo CY, Patil NG et al.. “Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis.” Surgical endoscopy (2005). PMID: 16247580 ↗

    L1SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Prognosis and Natural History
  83. [83]

    Manning RG, Aziz AQ. “Should laparoscopic cholecystectomy be practiced in the developing world?: the experience of the first training program in Afghanistan.” Annals of surgery (2009). PMID: 19387323 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors
  84. [84]

    Butte JM, Hameed M, Ball CG. “Hepato-pancreato-biliary emergencies for the acute care surgeon: etiology, diagnosis and treatment.” World journal of emergency surgery : WJES (2015). PMID: 25767562 ↗

    L5OTHERCited in: Epidemiology, Etiology and Risk Factors
  85. [85]

    Törnqvist B, Strömberg C, Akre O et al.. “Selective intraoperative cholangiography and risk of bile duct injury during cholecystectomy.” The British journal of surgery (2015). PMID: 25919401 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, History and Evolution of Treatment, Special Populations & Pregnancy
  86. [86]

    Reinsoo A, Kirsimägi Ü, Kibuspuu L et al.. “Cholecystostomy tube management in acute cholecystitis: a population-based cohort study.” European journal of trauma and emergency surgery : official publication of the European Trauma Society (2025). PMID: 41148352 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Prevention, Screening & Surveillance
  87. [87]

    Pesce A, Ramírez-Giraldo C, Matteucci M et al.. “Optimal timing for cholecystectomy following percutaneous cholecystostomy: insights from a multicenter retrospective cohort study.” Updates in surgery (2025). PMID: 40991133 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors, Complications and Their Management
  88. [88]

    Panin SI, Nechay TV, Sazhin AV et al.. “Intraoperative differences between near-infrared fluorescence cholangiography with indocyanine green and conventional white light laparoscopic cholecystectomy: an integrative review of evidence base.” BMC surgery (2026). PMID: 41699550 ↗

    L5SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  89. [89]

    Kuan LL, Oyebola T, Mavilakandy A et al.. “Retrospective Analysis of Outcomes Following Percutaneous Cholecystostomy for Acute Cholecystitis.” World journal of surgery (2020). PMID: 32266452 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History, Special Populations & Pregnancy
  90. [90]

    Yoshiya S, Minagawa R, Kamo K et al.. “Usability of Intraoperative Fluorescence Imaging with Indocyanine Green During Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage.” World journal of surgery (2019). PMID: 30105635 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization
  91. [91]

    Mizuno R, Nakajima S, Takashima T et al.. “Impact of Prior Endoscopic Sphincterotomy on Detection of Drug-Resistant Bacteria in Acute Cholecystitis.” World journal of surgery (2025). PMID: 40958143 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Acute Management and Resuscitation, History and Evolution of Treatment
  92. [92]

    Nishiwada S, Tanaka T, Hidaka T et al.. “Clinical Impact of Residual Gallbladder Neck-Cystic Duct Stones on Postoperative Outcomes in Acute Cholecystitis: A Retrospective Study.” Journal of laparoendoscopic & advanced surgical techniques. Part A (2026). PMID: 42420161 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors
  93. [93]

    Khoury T, Benson AA, Goldsztein M et al.. “Fully covered metal stents as a risk factor for acute cholecystitis in patients with biliary stricture: a multicenter retrospective study.” European journal of gastroenterology & hepatology (2026). PMID: 41925049 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  94. [94]

    El Asmar N, Rizk C, Malak D et al.. “Predictors of acute gangrenous cholecystitis and its complications: a retrospective cohort study.” BMC surgery (2025). PMID: 41382140 ↗

    L2COHORTCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation and Focused Examination, Diagnosis and Workup, Acute Management and Resuscitation, Special Populations & Pregnancy
  95. [95]

    Chang YR, Ahn YJ, Jang JY et al.. “Percutaneous cholecystostomy for acute cholecystitis in patients with high comorbidity and re-evaluation of treatment efficacy.” Surgery (2014). PMID: 24548617 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Special Populations & Pregnancy
  96. [96]

    Lipman JM, Claridge JA, Haridas M et al.. “Preoperative findings predict conversion from laparoscopic to open cholecystectomy.” Surgery (2007). PMID: 17950348 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization
  97. [97]

    Lucocq J, Hamilton D, Bakhiet A et al.. “Derivation and validation of a predictive model for subtotal cholecystectomy.” Surgical endoscopy (2024). PMID: 39285041 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  98. [98]

    Huang SS, Lin KW, Liu KL et al.. “Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis.” World journal of emergency surgery : WJES (2023). PMID: 38037062 ↗

    L1SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  99. [99]

    Roulin D, Saadi A, Di Mare L et al.. “Early Versus Delayed Cholecystectomy for Acute Cholecystitis, Are the 72 hours Still the Rule?: A Randomized Trial.” Annals of surgery (2016). PMID: 27741006 ↗

    L1RCTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Complications and Their Management, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  100. [100]

    Krishnamoorthi R, Jayaraj M, Thoguluva Chandrasekar V et al.. “EUS-guided versus endoscopic transpapillary gallbladder drainage in high-risk surgical patients with acute cholecystitis: a systematic review and meta-analysis.” Surgical endoscopy (2020). PMID: 32048019 ↗

    L1SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization, Special Populations & Pregnancy
  101. [101]

    Anderloni A, Buda A, Vieceli F et al.. “Endoscopic ultrasound-guided transmural stenting for gallbladder drainage in high-risk patients with acute cholecystitis: a systematic review and pooled analysis.” Surgical endoscopy (2016). PMID: 27059975 ↗

    L4SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  102. [102]

    Fabbri C, Binda C, Sbrancia M et al.. “Determinants of outcomes of transmural EUS-guided gallbladder drainage: systematic review with proportion meta-analysis and meta-regression.” Surgical endoscopy (2022). PMID: 35652964 ↗

    L4SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  103. [103]

    Irani SS, Sharma NR, Storm AC et al.. “Endoscopic Ultrasound-guided Transluminal Gallbladder Drainage in Patients With Acute Cholecystitis: A Prospective Multicenter Trial.” Annals of surgery (2022). PMID: 36537290 ↗

    L4OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Prevention, Screening & Surveillance
  104. [104]

    Parmar AD, Sheffield KM, Adhikari D et al.. “PREOP-Gallstones: A Prognostic Nomogram for the Management of Symptomatic Cholelithiasis in Older Patients.” Annals of surgery (2015). PMID: 25072449 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Complications and Their Management, Special Populations & Pregnancy
  105. [105]

    La Regina D, Di Giuseppe M, Cafarotti S et al.. “Antibiotic administration after cholecystectomy for acute mild-moderate cholecystitis: a PRISMA-compliant meta-analysis.” Surgical endoscopy (2018). PMID: 30327917 ↗

    L1SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Acute Management and Resuscitation, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  106. [106]

    Coco D, Leanza S. “Robotic-assisted surgery for acute abdominal emergencies: a systematic review of 1142 cases.” Journal of robotic surgery (2025). PMID: 40908371 ↗

    L4SR_OBSCited in: Clinical Presentation and Focused Examination
  107. [107]

    Gustafsson C, Dahlberg M, Sondén A et al.. “Is out-of-hours cholecystectomy for acute cholecystitis associated with complications?” The British journal of surgery (2020). PMID: 32335904 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Special Populations & Pregnancy
  108. [108]

    Guo Q, Li Y, Huang Y et al.. “Self-supervised learning model integrates plain and contrast-enhanced CT for preoperatively identifying gangrenous cholecystitis: a multicenter retrospective cohort study.” International journal of surgery (London, England) (2025). PMID: 40844296 ↗

    L2COHORTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  109. [109]

    Gustafsson C, Lindelius A, Törngren S et al.. “Surgeon-Performed Ultrasound in Diagnosing Acute Cholecystitis and Appendicitis.” World journal of surgery (2018). PMID: 29882098 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Special Populations & Pregnancy
  110. [110]

    Nakamura Y, Kuwahara M, Ito K et al.. “Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?” World journal of surgery (2023). PMID: 37000200 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  111. [111]

    Martellotto S, Dohan A, Pocard M. “Evaluation of the CT Scan as the First Examination for the Diagnosis and Therapeutic Strategy for Acute Cholecystitis.” World journal of surgery (2020). PMID: 32030439 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Acute Management and Resuscitation, Special Populations & Pregnancy
  112. [112]

    Loftus TJ, Brakenridge SC, Dessaigne CG et al.. “Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy.” World journal of surgery (2017). PMID: 28050668 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Acute Management and Resuscitation, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, History and Evolution of Treatment, Prognosis and Natural History
  113. [113]

    Luo Y, Makepe M, Yim A et al.. “An Acute General Surgical Unit (AGSU) Negates the Impact of the Tokyo Guidelines 2018 (TG18) Diagnostic Criteria for the Treatment of Acute Cholecystitis.” World journal of surgery (2019). PMID: 31384994 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Approach, Technique Selection and Perioperative Optimization
  114. [114]

    Zhu B, Zhang Z, Wang Y et al.. “Comparison of laparoscopic cholecystectomy for acute cholecystitis within and beyond 72 h of symptom onset during emergency admissions.” World journal of surgery (2012). PMID: 22806207 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  115. [115]

    Davidović M, Kolak J, Basić J et al.. “Age-Adjusted Charlson Comorbidity Index as a Predictor of Clinical Severity in Acute Cholecystitis: A Retrospective Cohort Study.” Diagnostics (Basel, Switzerland) (2026). PMID: 42196827 ↗

    L2COHORTCited in: Clinical Presentation and Focused Examination
  116. [116]

    Fox T, Chieng M, Dalkie N et al.. “Endoscopic Ultrasound-Guided Gallbladder Drainage Using Lumen-Apposing Metal Stents for Non-Surgical Candidates With Cholecystitis: A Prospective Cohort Study.” ANZ journal of surgery (2026). PMID: 41860060 ↗

    L4COHORTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Acute Management and Resuscitation, Operative Approach, Technique Selection and Perioperative Optimization, Special Populations & Pregnancy, Prevention, Screening & Surveillance
  117. [117]

    Boccatonda A, Brighenti A, Musmeci M et al.. “Ultrasound-guided percutaneous cholecystostomy for acute cholecystitis: a systematic review and meta-analysis.” Journal of ultrasound (2026). PMID: 41665843 ↗

    L4SR_OBSCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  118. [118]

    Patil NS, Kumar AH, Pamecha V et al.. “Cystic artery pseudoaneurysm-a rare complication of acute cholecystitis: review of literature.” Surgical endoscopy (2021). PMID: 34811584 ↗

    L5CASE_REPORTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  119. [119]

    Hernandez M, Murphy B, Aho JM et al.. “Validation of the AAST EGS acute cholecystitis grade and comparison with the Tokyo guidelines.” Surgery (2018). PMID: 29325783 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History, Special Populations & Pregnancy
  120. [120]

    López VH, Vatcheva K, Betancourt-Garcia MM et al.. “Impact of accountable care organizations on acute cholecystitis outcomes in the Rio Grande Valley.” Surgery (2022). PMID: 35034795 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Complications and Their Management, Special Populations & Pregnancy
  121. [121]

    Liang JL, Chen MC, Huang HY et al.. “Gallbladder carcinoma manifesting as acute cholecystitis: clinical and computed tomographic features.” Surgery (2009). PMID: 19744453 ↗

    L3OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Special Populations & Pregnancy
  122. [122]

    Sekioka A, Ota S, Ito T et al.. “How do magnetic resonance cholangiopancreatography findings predict conversion from laparoscopic cholecystectomy for acute cholecystitis to bailout procedures?” Surgery (2023). PMID: 37349250 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  123. [123]

    Muszynska C, Lundgren L, Lindell G et al.. “Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry.” Surgery (2017). PMID: 28400123 ↗

    L2OTHERCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  124. [124]

    Keyif MF, Bolat F. “Assessing the role of the triglyceride-glucose index in the diagnosis and risk stratification of acute cholecystitis: A retrospective study.” Medicine (2026). PMID: 41650061 ↗

    L2COHORTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification, Special Populations & Pregnancy
  125. [125]

    Makimoto S, Takami T, Hatano K et al.. “Xanthogranulomatous cholecystitis: a review of 31 patients.” Surgical endoscopy (2020). PMID: 32720174 ↗

    L4REVIEW_NARRATIVECited in: Clinical Presentation and Focused Examination, Diagnosis and Workup
  126. [126]

    Ullal TV, McLarty E, Cordova AY et al.. “Clinical features, diagnostic findings, and outcomes of emphysematous cholecystitis in 35 dogs: a retrospective case series.” Journal of veterinary internal medicine (2026). PMID: 42391600 ↗

    L4CASE_REPORTCited in: Clinical Presentation and Focused Examination, Diagnosis and Workup, Acute Management and Resuscitation
  127. [127]

    Wang X, Kang J, Li Y et al.. “Prospective randomized trial of triple port laparoscopic cholecystectomy combined with choledochoscopic common bile duct exploration and primary closure for acute abdominal pain.” Scientific reports (2026). PMID: 41571833 ↗

    L1RCTCited in: Clinical Presentation and Focused Examination, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Special Populations & Pregnancy
  128. [128]

    Ahmed O, Rogers AC, Bolger JC et al.. “Meta-analysis of outcomes of endoscopic ultrasound-guided gallbladder drainage versus percutaneous cholecystostomy for the management of acute cholecystitis.” Surgical endoscopy (2018). PMID: 29404731 ↗

    L1SR_OBSCited in: Diagnosis and Workup
  129. [129]

    Baron TH, Jorge I, Husnain A et al.. “Comprehensive Review of the Management of Patients With Acute Cholecystitis Who Are Ineligible for Surgery.” Annals of surgery (2025). PMID: 40255177 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  130. [130]

    Canakis A, Tugarinov N, Deliwala S et al.. “Clinical outcomes of Endoscopic ultrasound--guided gallbladder drainage in patients with acute cholecystitis with ≥1 year of follow-up: a systematic review and meta-analysis.” Gastrointestinal endoscopy (2025). PMID: 40706905 ↗

    L1SR_OBSCited in: Diagnosis and Workup, Prevention, Screening & Surveillance
  131. [131]

    Yodying H, Viriyaroj V, Rookkachart T et al.. “Operative outcomes of interval cholecystectomy after gallbladder drainage for acute cholecystitis: a systematic review and meta-analysis comparing endoscopic and percutaneous approaches.” BMC surgery (2026). PMID: 41803774 ↗

    L1SR_OBSCited in: Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  132. [132]

    Hu L, Xu Y, Wang A et al.. “Comparison of Three Gallbladder Drainage Methods for Acute Cholecystitis: A Systematic Review With Network Meta-Analysis.” ANZ journal of surgery (2025). PMID: 41472653 ↗

    L1SR_OBSCited in: Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  133. [133]

    Kim JH, Kim WH, Kim JH et al.. “Unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy: focus on acute cholecystitis.” World journal of surgery (2010). PMID: 19898893 ↗

    L4OTHERCited in: Diagnosis and Workup, Prevention, Screening & Surveillance
  134. [134]

    Hadad SM, Vaidya JS, Baker L et al.. “Delay from symptom onset increases the conversion rate in laparoscopic cholecystectomy for acute cholecystitis.” World journal of surgery (2007). PMID: 17483986 ↗

    L3OTHERCited in: Diagnosis and Workup
  135. [135]

    Melloul E, Denys A, Demartines N et al.. “Percutaneous drainage versus emergency cholecystectomy for the treatment of acute cholecystitis in critically ill patients: does it matter?” World journal of surgery (2011). PMID: 21318431 ↗

    L3OTHERCited in: Diagnosis and Workup, Acute Management and Resuscitation
  136. [136]

    Ahn KS, Yoon YS, Han HS et al.. “Use of Liver Function Tests as First-line Diagnostic Tools for Predicting Common Bile Duct Stones in Acute Cholecystitis Patients.” World journal of surgery (2016). PMID: 27094560 ↗

    L3OTHERCited in: Diagnosis and Workup
  137. [137]

    Șerban RI, Alexandru I, Tarta C et al.. “The Diagnostic Accuracy of Neutrophil-to-Lymphocyte Ratio (NLR) Compared to C-Reactive Protein (CRP) in Patients with Acute Cholecystitis: A Systematic Review and Meta-Analysis.” Diagnostics (Basel, Switzerland) (2026). PMID: 42122065 ↗

    L1SR_OBSCited in: Diagnosis and Workup
  138. [138]

    Corral JE, Das A, Krӧner PT et al.. “Cost effectiveness of endoscopic gallbladder drainage to treat acute cholecystitis in poor surgical candidates.” Surgical endoscopy (2019). PMID: 31350611 ↗

    L2REVIEW_NARRATIVECited in: Diagnosis and Workup, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  139. [139]

    Lisotti A, Linguerri R, Bacchilega I et al.. “EUS-guided gallbladder drainage in high-risk surgical patients with acute cholecystitis-procedure outcomes and evaluation of mortality predictors.” Surgical endoscopy (2021). PMID: 33507383 ↗

    L3OTHERCited in: Diagnosis and Workup
  140. [140]

    Borzellino G, Steccanella F, Mantovani W et al.. “Predictive factors for the diagnosis of severe acute cholecystitis in an emergency setting.” Surgical endoscopy (2013). PMID: 23549766 ↗

    L3OTHERCited in: Diagnosis and Workup, Severity, Surgical Scoring and Risk Stratification
  141. [141]

    Kostrzewa M, Zener R, Swanström LL et al.. “An alternative percutaneous technique for gallbladder drainage using lumen-apposing metal stents.” Surgical endoscopy (2019). PMID: 31392512 ↗

    L5OTHERCited in: Diagnosis and Workup
  142. [142]

    Spadaccini M, Franchellucci G, Auriemma F et al.. “EUS-Guided Gallbladder Drainage in Acute Cholecystitis With Contained Perforation: An International Multicenter Study.” Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (2026). PMID: 42376949 ↗

    L3OTHERCited in: Diagnosis and Workup
  143. [143]

    Godat S, Philippart M, Keshavjee B et al.. “Endoscopic Ultrasound-Guided Gallbladder Drainage in Patients at High Surgical Risk With Acute Cholecystitis and Gallbladder Perforation.” Journal of gastroenterology and hepatology (2026). PMID: 42128424 ↗

    L4OTHERCited in: Diagnosis and Workup
  144. [144]

    Tiyarattanachai T, Mehta V, Rusu M et al.. “Cystic Artery Velocity: Evaluation of Performance in the Sonographic Diagnosis of Acute Cholecystitis.” Academic radiology (2026). PMID: 42025518 ↗

    L3OTHERCited in: Diagnosis and Workup
  145. [145]

    Gutt CN, Encke J, Köninger J et al.. “Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304).” Annals of surgery (2013). PMID: 24022431 ↗

    L1RCTCited in: Severity, Surgical Scoring and Risk Stratification, Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  146. [146]

    Törnqvist B, Waage A, Zheng Z et al.. “Severity of Acute Cholecystitis and Risk of Iatrogenic Bile Duct Injury During Cholecystectomy, a Population-Based Case-Control Study.” World journal of surgery (2016). PMID: 26669783 ↗

    L3CASE_CONTROLCited in: Severity, Surgical Scoring and Risk Stratification, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  147. [147]

    Lim PW, Tan PH, Lillemoe KD et al.. “A 10-Year Real-world Assessment of Longitudinal Outcomes Following Bailout Procedures for Severe Cholecystitis.” Annals of surgery (2025). PMID: 40528741 ↗

    L3OTHERCited in: Severity, Surgical Scoring and Risk Stratification, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History, Special Populations & Pregnancy
  148. [148]

    Fukuda N, Wada J, Niki M et al.. “Factors predicting mortality in emergency abdominal surgery in the elderly.” World journal of emergency surgery : WJES (2012). PMID: 22578159 ↗

    L4OTHERCited in: Severity, Surgical Scoring and Risk Stratification, Acute Management and Resuscitation
  149. [149]

    Bonomo RA, Edwards MS, Abrahamian FM et al.. “2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intraabdominal Infections: Diagnostic Imaging of Suspected Acute Cholecystitis and Acute Cholangitis in Adults, Children, and Pregnant People.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2024). PMID: 38963820 ↗

    L1GUIDELINECited in: Severity, Surgical Scoring and Risk Stratification
  150. [150]

    Jensen PUD, Graabæk F, Tolstrup MB et al.. “Perioperative antibiotics for mild or moderate acute cholecystitis - A systematic review and meta-analysis.” American journal of surgery (2026). PMID: 41916156 ↗

    L1SR_OBSCited in: Severity, Surgical Scoring and Risk Stratification, Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  151. [151]

    Terrone A, Di Martino M, Saeidi S et al.. “Percutaneous cholecystostomy in elderly patients with acute cholecystitis: a systematic review and meta-analysis.” Updates in surgery (2024). PMID: 38372956 ↗

    L2SR_OBSCited in: Severity, Surgical Scoring and Risk Stratification
  152. [152]

    Miyoshi Y, Hashida S, Ohki M et al.. “Safety and Feasibility of Early Laparoscopic Cholecystectomy in High-Risk Acute Cholecystitis: A Critical Evaluation of Tokyo Guidelines 2018 Risk Stratification.” World journal of surgery (2026). PMID: 42112895 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  153. [153]

    Massoumi RL, Trevino CM, Webb TP. “Postoperative Complications of Laparoscopic Cholecystectomy for Acute Cholecystitis: A Comparison to the ACS-NSQIP Risk Calculator and the Tokyo Guidelines.” World journal of surgery (2017). PMID: 27834012 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification, Complications and Their Management
  154. [154]

    Lin MH, Ni CF, Chiang HJ et al.. “Optimal Timing of Percutaneous Cholecystostomy across Different Grades of Acute Cholecystitis: A Retrospective Cohort Study.” Journal of vascular and interventional radiology : JVIR (2025). PMID: 40239892 ↗

    L2COHORTCited in: Severity, Surgical Scoring and Risk Stratification, Prevention, Screening & Surveillance
  155. [155]

    Yodying H, Somtasana K, Toemakharathaworn K. “Neutrophil percentage-to-albumin ratio as a predictor of conservative treatment failure in acute cholecystitis: a retrospective cohort study.” BMC surgery (2025). PMID: 40022049 ↗

    L2COHORTCited in: Severity, Surgical Scoring and Risk Stratification
  156. [156]

    Abe T, Kobayashi T, Kuroda S et al.. “Multicenter analysis of the efficacy of early cholecystectomy and preoperative cholecystostomy for severe acute cholecystitis: a retrospective study of data from the multi-institutional database of the Hiroshima Surgical Study Group of Clinical Oncology.” BMC gastroenterology (2024). PMID: 39354370 ↗

    L2COHORTCited in: Severity, Surgical Scoring and Risk Stratification, Prevention, Screening & Surveillance
  157. [157]

    Miyata T, Matsui D, Fujiwara Y et al.. “Predictive factors for developing acute cholangitis and/or cholecystitis in patients undergoing delayed cholecystectomy: A retrospective study.” Asian journal of surgery (2020). PMID: 32709456 ↗

    L2COHORTCited in: Severity, Surgical Scoring and Risk Stratification
  158. [158]

    Lee KJ, Jung JH, Park SW et al.. “Clinical impact of percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy in patients with moderate to severe acute cholecystitis: A propensity score-matched case-control study.” American journal of surgery (2025). PMID: 41317682 ↗

    L2CASE_CONTROLCited in: Severity, Surgical Scoring and Risk Stratification, Special Populations & Pregnancy
  159. [159]

    Sarmiento-Altamirano D, Moyano-Vidal LM. “The 48-h window of opportunity: patient and health system-related predictors of surgical severity in symptomatic cholelithiasis.” Surgical endoscopy (2026). PMID: 41703042 ↗

    L4OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  160. [160]

    Sanjay P, Yeeting S, Whigham C et al.. “Endoscopic sphincterotomy and interval cholecystectomy are reasonable alternatives to index cholecystectomy in severe acute gallstone pancreatitis (GSP).” Surgical endoscopy (2007). PMID: 18071797 ↗

    L2REVIEW_NARRATIVECited in: Severity, Surgical Scoring and Risk Stratification
  161. [161]

    Low SW, Iyer SG, Chang SK et al.. “Laparoscopic cholecystectomy for acute cholecystitis: safe implementation of successful strategies to reduce conversion rates.” Surgical endoscopy (2009). PMID: 19263131 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  162. [162]

    Bickel A, Hoffman RS, Loberant N et al.. “Timing of percutaneous cholecystostomy affects conversion rate of delayed laparoscopic cholecystectomy for severe acute cholecystitis.” Surgical endoscopy (2015). PMID: 26139479 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  163. [163]

    Gerard J, Luu MB, Poirier J et al.. “Acute cholecystitis: comparing clinical outcomes with TG13 severity and intended laparoscopic versus open cholecystectomy in difficult operative cases.” Surgical endoscopy (2018). PMID: 29523984 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  164. [164]

    Loozen CS, Blessing MM, van Ramshorst B et al.. “The optimal treatment of patients with mild and moderate acute cholecystitis: time for a revision of the Tokyo Guidelines.” Surgical endoscopy (2017). PMID: 28127715 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  165. [165]

    Amirthalingam V, Low JK, Woon W et al.. “Tokyo Guidelines 2013 may be too restrictive and patients with moderate and severe acute cholecystitis can be managed by early cholecystectomy too.” Surgical endoscopy (2016). PMID: 27804044 ↗

    L2OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  166. [166]

    Chuang SH, Hung MC, Huang SW et al.. “Single-incision laparoscopic common bile duct exploration in 101 consecutive patients: choledochotomy, transcystic, and transfistulous approaches.” Surgical endoscopy (2017). PMID: 28643057 ↗

    L4OTHERCited in: Severity, Surgical Scoring and Risk Stratification
  167. [167]

    Renau G, Abelló D, Sabench F et al.. “C-reactive protein as a predictor of complicated acute cholecystitis: A cohort study.” Revista de gastroenterologia de Mexico (English) (2025). PMID: 40494691 ↗

    L2COHORTCited in: Severity, Surgical Scoring and Risk Stratification
  168. [168]

    Ramírez-Giraldo C, Van-Londoño I, Pesce A. “Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review.” World journal of emergency surgery : WJES (2025). PMID: 39794804 ↗

    L2SR_OBSCited in: Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  169. [169]

    Wang CH, Chou HC, Liu KL et al.. “Long-term outcome of patients with acute cholecystitis receiving antibiotic treatment: a retrospective cohort study.” World journal of surgery (2014). PMID: 24178182 ↗

    L2COHORTCited in: Acute Management and Resuscitation, Prognosis and Natural History, Prevention, Screening & Surveillance
  170. [170]

    Coccolini F, Cucinotta E, Mingoli A et al.. “Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines.” Updates in surgery (2023). PMID: 38153659 ↗

    L1GUIDELINECited in: Acute Management and Resuscitation
  171. [171]

    Ceribelli C, Adami EA, Mattia S et al.. “Bedside diagnostic laparoscopy for critically ill patients: a retrospective study of 62 patients.” Surgical endoscopy (2012). PMID: 22710654 ↗

    L4COHORTCited in: Acute Management and Resuscitation
  172. [172]

    Haas I, Lahat E, Griton Y et al.. “Percutaneous aspiration of the gall bladder for the treatment of acute cholecystitis: a prospective study.” Surgical endoscopy (2015). PMID: 26201413 ↗

    L4COHORTCited in: Acute Management and Resuscitation
  173. [173]

    Park SE, Lee TY, Seo CH et al.. “Assessing antibiotic effectiveness for reducing postoperative infectious complications in acute cholecystitis: a multicenter randomized controlled trial.” International journal of surgery (London, England) (2025). PMID: 40143735 ↗

    L1RCTCited in: Acute Management and Resuscitation, History and Evolution of Treatment
  174. [174]

    Al Azzawi M, Cullinane C, Devine M et al.. “Management of percutaneous cholecystostomy drains: a survey of real-world practices across Ireland and the UK.” World journal of emergency surgery : WJES (2026). PMID: 41723454 ↗

    L5OTHERCited in: Acute Management and Resuscitation
  175. [175]

    Loehrer AP, Chang DC, Scott JW et al.. “Association of the Affordable Care Act Medicaid Expansion With Access to and Quality of Care for Surgical Conditions.” JAMA surgery (2018). PMID: 29365029 ↗

    L2OTHERCited in: Acute Management and Resuscitation
  176. [176]

    Ramírez-Giraldo C, Rodriguez Barbosa C, Isaza-Restrepo A et al.. “Predictive factors associated with Bile culture positivity And phenotypiCal antIbiogram resistance patterns in patients taken to LaparOscopic cholecystectomy (BACILO): protocol for a prospective observational cohort study and development of a prognostic prediction model.” BMJ open (2024). PMID: 39486833 ↗

    L5COHORTCited in: Acute Management and Resuscitation
  177. [177]

    Wei Y, Ramson DM, Smith JA et al.. “Prognostic Factors and Predictive Models for Rates of Mortality and Morbidity Following Percutaneous Cholecystostomy: A Retrospective Cohort Study at Counties Manukau Between 2022 and 2024.” ANZ journal of surgery (2026). PMID: 42290247 ↗

    L3COHORTCited in: Acute Management and Resuscitation, Prognosis and Natural History
  178. [178]

    Heo D, Wijaya P, Latulumamina NH et al.. “An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials on Postoperative Antibiotic Administration After Cholecystectomy for Acute Mild to Moderate Cholecystitis.” Cureus (2026). PMID: 41658841 ↗

    L1SR_MA_RCTCited in: Acute Management and Resuscitation
  179. [179]

    Ingraham A, Nathens A, Peitzman A et al.. “Assessment of emergency general surgery care based on formally developed quality indicators.” Surgery (2017). PMID: 28647046 ↗

    L5OTHERCited in: Acute Management and Resuscitation, Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  180. [180]

    Pavurala RB, Li D, Porter K et al.. “Percutaneous cholecystostomy-tube for high-risk patients with acute cholecystitis: current practice and implications for future research.” Surgical endoscopy (2019). PMID: 30604258 ↗

    L2OTHERCited in: Acute Management and Resuscitation
  181. [181]

    Ausania F, Guzman Suarez S, Alvarez Garcia H et al.. “Gallbladder perforation: morbidity, mortality and preoperative risk prediction.” Surgical endoscopy (2014). PMID: 25159627 ↗

    L3OTHERCited in: Acute Management and Resuscitation
  182. [182]

    Ramírez-Giraldo C, Rodriguez Barbosa C, Avendaño-Morales V et al.. “Predictive factors associated with bile culture positivity: a model development and diagnostic test accuracy study.” Surgical endoscopy (2025). PMID: 41219561 ↗

    L2OTHERCited in: Acute Management and Resuscitation
  183. [183]

    Lin D, Deng L, Zheng W et al.. “Silent evolution: β-lactam resistance acquisition in a virulent Salmonella enterica paratyphi B during systemic therapy despite clinical cure; A case report.” International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (2026). PMID: 41916494 ↗

    L4CASE_REPORTCited in: Acute Management and Resuscitation, History and Evolution of Treatment
  184. [184]

    Blohm M, Sandblom G, Enochsson L et al.. “Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial).” World journal of emergency surgery : WJES (2024). PMID: 39538278 ↗

    L1RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, History and Evolution of Treatment, Special Populations & Pregnancy
  185. [185]

    Gurusamy K, Samraj K, Gluud C et al.. “Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.” The British journal of surgery (2010). PMID: 20035546 ↗

    L1SR_MA_RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  186. [186]

    Fanciulli G, Favara G, Maugeri A et al.. “Comparing percutaneous treatment and cholecystectomy outcomes in acute cholecystitis patients: a systematic review and meta-analysis.” World journal of emergency surgery : WJES (2025). PMID: 40483437 ↗

    L2SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  187. [187]

    Borzellino G, Khuri S, Pisano M et al.. “Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis: a meta-analysis of randomized clinical trials.” World journal of emergency surgery : WJES (2021). PMID: 33766077 ↗

    L1SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, History and Evolution of Treatment
  188. [188]

    Macafee DA, Humes DJ, Bouliotis G et al.. “Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease.” The British journal of surgery (2009). PMID: 19672930 ↗

    L1RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  189. [189]

    Loozen CS, Kortram K, Kornmann VN et al.. “Randomized clinical trial of extended versus single-dose perioperative antibiotic prophylaxis for acute calculous cholecystitis.” The British journal of surgery (2017). PMID: 28121041 ↗

    L1RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, History and Evolution of Treatment, Special Populations & Pregnancy
  190. [190]

    Teoh AY, Chong CN, Wong J et al.. “Routine early laparoscopic cholecystectomy for acute cholecystitis after conclusion of a randomized controlled trial.” The British journal of surgery (2007). PMID: 17535013 ↗

    L4RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  191. [191]

    Wu XD, Tian X, Liu MM et al.. “Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis.” The British journal of surgery (2015). PMID: 26265548 ↗

    L1SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  192. [192]

    Mytton J, Daliya P, Singh P et al.. “Outcomes Following an Index Emergency Admission With Cholecystitis: A National Cohort Study.” Annals of surgery (2021). PMID: 31567508 ↗

    L2COHORTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History
  193. [193]

    Kumar SS, Collings AT, Wunker C et al.. “SAGES guidelines for the use of laparoscopy during pregnancy.” Surgical endoscopy (2024). PMID: 38700549 ↗

    L1GUIDELINECited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, History and Evolution of Treatment, Special Populations & Pregnancy
  194. [194]

    Lyu Y, Cheng Y, Wang B et al.. “Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials.” Surgical endoscopy (2018). PMID: 30167953 ↗

    L1SR_MA_RCTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  195. [195]

    . “Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases.” The British journal of surgery (2016). PMID: 27748962 ↗

    L2COHORTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Special Populations & Pregnancy
  196. [196]

    Loozen CS, Oor JE, van Ramshorst B et al.. “Conservative treatment of acute cholecystitis: a systematic review and pooled analysis.” Surgical endoscopy (2016). PMID: 27317033 ↗

    L2SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Prevention, Screening & Surveillance
  197. [197]

    Martins MAB, Meine GC, Gadelha JG et al.. “Operative versus nonoperative treatment of acute cholecystitis during pregnancy: a systematic review and meta-analysis.” Surgical endoscopy (2025). PMID: 40610639 ↗

    L2SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History, Special Populations & Pregnancy
  198. [198]

    Cao AM, Eslick GD, Cox MR. “Early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case-control studies.” Surgical endoscopy (2015). PMID: 26139487 ↗

    L3SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History
  199. [199]

    Kao LS, Ball CG, Chaudhury PK. “Evidence-based Reviews in Surgery: Early Cholecystectomy for Cholecystitis.” Annals of surgery (2018). PMID: 29916874 ↗

    L1REVIEW_NARRATIVECited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  200. [200]

    Zangbar B, Rhee P, Pandit V et al.. “Seasonal Variation in Emergency General Surgery.” Annals of surgery (2016). PMID: 25876008 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History
  201. [201]

    Rios-Diaz AJ, Oliver EA, Bevilacqua LA et al.. “Is It Safe to Manage Acute Cholecystitis Nonoperatively During Pregnancy?: A Nationwide Analysis of Morbidity According to Management Strategy.” Annals of surgery (2020). PMID: 33759834 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  202. [202]

    Smith TJ, Manske JG, Mathiason MA et al.. “Changing trends and outcomes in the use of percutaneous cholecystostomy tubes for acute cholecystitis.” Annals of surgery (2013). PMID: 23263191 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Special Populations & Pregnancy
  203. [203]

    Sermonesi G, Tian BWCA, Vallicelli C et al.. “Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma.” World journal of emergency surgery : WJES (2023). PMID: 38066631 ↗

    L5OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  204. [204]

    Kryvoruchko IA. “Percutaneous versus surgical treatment of acute cholecystitis.” World journal of emergency surgery : WJES (2026). PMID: 42374556 ↗

    L5REVIEW_NARRATIVECited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  205. [205]

    Ramia JM, Serradilla-Martín M, Villodre C et al.. “International Delphi consensus on the management of percutaneous choleystostomy in acute cholecystitis (E-AHPBA, ANS, WSES societies).” World journal of emergency surgery : WJES (2024). PMID: 39396036 ↗

    L5OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  206. [206]

    Chen L. “Percutaneous vs. surgical management in acute cholecystitis: addressing selection bias in meta-analyses.” World journal of emergency surgery : WJES (2026). PMID: 41689113 ↗

    L5OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  207. [207]

    Jamal Z, Talal MA, Saeed J et al.. “Is robotic surgery ready for emergency cholecystectomy? A systematic review and meta-analysis of robotic versus laparoscopic approach in acute cholecystitis.” Journal of robotic surgery (2026). PMID: 41521240 ↗

    L2SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History
  208. [208]

    Villani V, Kao LS, Fong Y. “The Difficult Cholecystectomy.” JAMA surgery (2026). PMID: 41091499 ↗

    L5REVIEW_NARRATIVECited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  209. [209]

    Acker RC, Ginzberg SP, Sharpe J et al.. “Operative vs Nonoperative Treatment of Acute Cholecystitis in Older Adults With Multimorbidity.” JAMA surgery (2025). PMID: 40238117 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  210. [210]

    Loehrer AP, Song Z, Auchincloss HG et al.. “Massachusetts health care reform and reduced racial disparities in minimally invasive surgery.” JAMA surgery (2013). PMID: 24089326 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  211. [211]

    Wilson E, Gurusamy K, Gluud C et al.. “Cost-utility and value-of-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.” The British journal of surgery (2010). PMID: 20035545 ↗

    L5OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History
  212. [212]

    Gad MM, Ayad Q, Elgamal MM et al.. “Cholecystectomy versus conservative management for patients with uncomplicated symptomatic gallstones and cholecystitis: an updated systematic review and meta-analysis.” BMC surgery (2026). PMID: 42265664 ↗

    L1SR_OBSCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Prognosis and Natural History
  213. [213]

    Köstenbauer JK, Gandy RC, Close J et al.. “Factors Affecting Early Cholecystectomy for Acute Cholecystitis in Older People-A Population-Based Study.” World journal of surgery (2023). PMID: 37133808 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy
  214. [214]

    Pang KW, Tan CH, Loh S et al.. “Outcomes of Percutaneous Cholecystostomy for Acute Cholecystitis.” World journal of surgery (2016). PMID: 27255942 ↗

    L4OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Complications and Their Management, Prognosis and Natural History, Special Populations & Pregnancy, Prevention, Screening & Surveillance
  215. [215]

    Tauriainen A, Biancari F, Tauriainen T. “Comparative Analysis of Three-Versus Two-dimensional Imaging in Laparoscopic Cholecystectomy.” World journal of surgery (2021). PMID: 33475802 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization
  216. [216]

    Vega EA, Yamashita S, Chun YS et al.. “Effective Laparoscopic Management Lymph Node Dissection for Gallbladder Cancer.” Annals of surgical oncology (2017). PMID: 28168387 ↗

    L4CASE_REPORTCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  217. [217]

    Lucocq J, Patil P, Scollay J. “Acute cholecystitis: Delayed cholecystectomy has lesser perioperative morbidity compared to emergency cholecystectomy.” Surgery (2022). PMID: 35461704 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  218. [218]

    Csikesz NG, Tseng JF, Shah SA. “Trends in surgical management for acute cholecystitis.” Surgery (2008). PMID: 18656637 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Prognosis and Natural History
  219. [219]

    Lois A, Fennern E, Cook S et al.. “Patterns of care after cholecystostomy tube placement.” Surgical endoscopy (2021). PMID: 34076767 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  220. [220]

    Ramírez-Giraldo C, Bimbo C, Fabbri N et al.. “Surgical outcomes of conventional versus indocyanine green fluorescence-guided laparoscopic cholecystectomy in acute cholecystitis: a propensity score-matched analysis.” Surgical endoscopy (2025). PMID: 40571795 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice, Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  221. [221]

    Yoshida MC, Ogami T, Ho K et al.. “Patient and surgeon factors contributing to bailout cholecystectomies: a single-institutional retrospective analysis.” Surgical endoscopy (2022). PMID: 34981223 ↗

    L2OTHERCited in: Operative Decision-Making: Indications, Timing and the Operative-vs-Nonoperative Choice
  222. [222]

    Toro A, Rapisarda M, Maugeri D et al.. “Acute cholecystitis: a new technique to use carefully.” World journal of emergency surgery : WJES (2025). PMID: 41402820 ↗

    L5OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization
  223. [223]

    Camarotti TAF, Lenzi MC, Cardoso JHCO et al.. “Clinical outcomes of robotic-assisted versus laparoscopic cholecystectomy in nonelective procedures: A systematic review and meta-analysis.” The journal of trauma and acute care surgery (2025). PMID: 41417656 ↗

    L2SR_OBSCited in: Operative Approach, Technique Selection and Perioperative Optimization, Complications and Their Management
  224. [224]

    D'Acapito F, Cucchetti A, Solaini L et al.. “Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy.” World journal of surgery (2022). PMID: 36459198 ↗

    L5OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization
  225. [225]

    Bucher P, Pugin F, Buchs N et al.. “Single port access laparoscopic cholecystectomy (with video).” World journal of surgery (2009). PMID: 19116734 ↗

    L4OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization
  226. [226]

    Abe K, Suzuki K, Yahagi M et al.. “The Efficacy of PTGBD for Acute Cholecystitis Based on the Tokyo Guidelines 2018.” World journal of surgery (2019). PMID: 31399798 ↗

    L2OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization
  227. [227]

    Said M, Alzyoud A, Alkhawaja F et al.. “Outcomes and complications of three-incision versus single-incision laparoscopic cholecystectomy: a systematic review and meta-analysis.” Updates in surgery (2026). PMID: 42417939 ↗

    L2SR_OBSCited in: Operative Approach, Technique Selection and Perioperative Optimization
  228. [228]

    Fronza JS, Linn JG, Nagle AP et al.. “A single institution's experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy.” Surgery (2010). PMID: 20708764 ↗

    L2OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization
  229. [229]

    Huy TC, Shenoy R, Russell MM et al.. “Patient and hospital factors influence surgical approach in treatment of acute cholecystitis.” Surgical endoscopy (2024). PMID: 39285035 ↗

    L2OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization, Special Populations & Pregnancy
  230. [230]

    Giannopoulos S, Makhecha K, Madduri S et al.. “What is the ideal timing of cholecystectomy after percutaneous cholecystostomy for acute cholecystitis?” Surgical endoscopy (2023). PMID: 37567978 ↗

    L2OTHERCited in: Operative Approach, Technique Selection and Perioperative Optimization, History and Evolution of Treatment
  231. [231]

    Komatsu M, Yokoyama N, Katada T et al.. “Learning curve for the surgical time of laparoscopic cholecystectomy performed by surgical trainees using the three-port method: how many cases are needed for stabilization?” Surgical endoscopy (2022). PMID: 36171452 ↗

    L4REVIEW_NARRATIVECited in: Operative Approach, Technique Selection and Perioperative Optimization
  232. [232]

    Fugazzola P, Cobianchi L, Di Martino M et al.. “Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study.” World journal of emergency surgery : WJES (2023). PMID: 36934276 ↗

    L2OTHERCited in: Complications and Their Management
  233. [233]

    Rothman JP, Burcharth J, Pommergaard HC et al.. “Cholecystectomy During the Weekend Increases Patients' Length of Hospital Stay.” World journal of surgery (2016). PMID: 26563218 ↗

    L2OTHERCited in: Complications and Their Management, Prognosis and Natural History
  234. [234]

    Järvinen HJ, Hästbacka J. “Early cholecystectomy for acute cholecystitis: a prospective randomized study.” Annals of surgery (1980). PMID: 6445180 ↗

    L1RCTCited in: History and Evolution of Treatment
  235. [235]

    Stone HH, Hooper CA, Millikan WJ. “Abdominal drainage following appendectomy and cholecystectomy.” Annals of surgery (1978). PMID: 646499 ↗

    L2RCTCited in: History and Evolution of Treatment
  236. [236]

    Lo CM, Liu CL, Fan ST et al.. “Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.” Annals of surgery (1998). PMID: 9563529 ↗

    L1RCTCited in: History and Evolution of Treatment
  237. [237]

    McArthur P, Cuschieri A, Sells RA et al.. “Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis.” The British journal of surgery (1975). PMID: 1104043 ↗

    L1RCTCited in: History and Evolution of Treatment
  238. [238]

    Lai PB, Kwong KH, Leung KL et al.. “Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.” The British journal of surgery (1998). PMID: 9667702 ↗

    L1RCTCited in: History and Evolution of Treatment
  239. [239]

    Johansson M, Thune A, Nelvin L et al.. “Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis.” The British journal of surgery (2005). PMID: 15584058 ↗

    L1RCTCited in: History and Evolution of Treatment
  240. [240]

    Berggren U, Gordh T, Grama D et al.. “Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses.” The British journal of surgery (1994). PMID: 7953415 ↗

    L1RCTCited in: History and Evolution of Treatment
  241. [241]

    Hammarström LE, Holmin T, Stridbeck H et al.. “Long-term follow-up of a prospective randomized study of endoscopic versus surgical treatment of bile duct calculi in patients with gallbladder in situ.” The British journal of surgery (1995). PMID: 8535807 ↗

    L1RCTCited in: History and Evolution of Treatment
  242. [242]

    Assalia A, Kopelman D, Hashmonai M. “Emergency minilaparotomy cholecystectomy for acute cholecystitis: prospective randomized trial--implications for the laparoscopic era.” World journal of surgery (1997). PMID: 9204744 ↗

    L1RCTCited in: History and Evolution of Treatment
  243. [243]

    Schoenfield LJ, Berci G, Carnovale RL et al.. “The effect of ursodiol on the efficacy and safety of extracorporeal shock-wave lithotripsy of gallstones. The Dornier National Biliary Lithotripsy Study.” The New England journal of medicine (1990). PMID: 2215608 ↗

    L1RCTCited in: History and Evolution of Treatment
  244. [244]

    Kiviluoto T, Sirén J, Luukkonen P et al.. “Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis.” Lancet (London, England) (1998). PMID: 9652612 ↗

    L1RCTCited in: History and Evolution of Treatment
  245. [245]

    Boerma D, Rauws EA, Keulemans YC et al.. “Wait-and-see policy or laparoscopic cholecystectomy after endoscopic sphincterotomy for bile-duct stones: a randomised trial.” Lancet (London, England) (2002). PMID: 12241833 ↗

    L1RCTCited in: History and Evolution of Treatment
  246. [246]

    Bergman JJ, Rauws EA, Fockens P et al.. “Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones.” Lancet (London, England) (1997). PMID: 9113010 ↗

    L1RCTCited in: History and Evolution of Treatment
  247. [247]

    Eldar S, Sabo E, Nash E et al.. “Laparoscopic cholecystectomy for acute cholecystitis: prospective trial.” World journal of surgery (1997). PMID: 9204745 ↗

    L4TRIAL_NONRANDOMCited in: History and Evolution of Treatment
  248. [248]

    Maher JW, Summers RW, Dean TR et al.. “Early results of combined electrohydraulic shock-wave lithotripsy and oral litholytic therapy of gallbladder stones at the University of Iowa.” Surgery (1990). PMID: 2218875 ↗

    L1RCTCited in: History and Evolution of Treatment
  249. [249]

    Gibney EJ. “Asymptomatic gallstones.” The British journal of surgery (1990). PMID: 2187558 ↗

    L5REVIEW_NARRATIVECited in: History and Evolution of Treatment
  250. [250]

    She WH, Cheung TT, Chan MY et al.. “Routine use of ICG to enhance operative safety in emergency laparoscopic cholecystectomy: a randomized controlled trial.” Surgical endoscopy (2022). PMID: 35194663 ↗

    L1RCTCited in: History and Evolution of Treatment
  251. [251]

    Kolla SB, Aggarwal S, Kumar A et al.. “Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial.” Surgical endoscopy (2004). PMID: 15803229 ↗

    L1RCTCited in: History and Evolution of Treatment
  252. [252]

    Borchert D, Federlein M, Rückbeil O et al.. “Prospective evaluation of transvaginal assisted cholecystectomy.” Surgical endoscopy (2012). PMID: 22717796 ↗

    L2RCTCited in: History and Evolution of Treatment
  253. [253]

    Salman MA, Salman A, Mohamed US et al.. “Ursodeoxycholic acid for the prevention of gall stones after laparoscopic sleeve gastrectomy: a prospective controlled study.” Surgical endoscopy (2022). PMID: 35020052 ↗

    L1RCTCited in: History and Evolution of Treatment
  254. [254]

    Voyles CR, Sanders DL, Hogan R. “Common bile duct evaluation in the era of laparoscopic cholecystectomy. 1050 cases later.” Annals of surgery (1994). PMID: 8203985 ↗

    L4OTHERCited in: History and Evolution of Treatment
  255. [255]

    Dunnington G, Alfrey E, Sampliner R et al.. “Natural history of cholelithiasis in patients with alcoholic cirrhosis (cholelithiasis in cirrhotic patients).” Annals of surgery (1987). PMID: 3827357 ↗

    L4OTHERCited in: History and Evolution of Treatment
  256. [256]

    Peters JH, Ellison EC, Innes JT et al.. “Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients.” Annals of surgery (1991). PMID: 1824674 ↗

    L4OTHERCited in: History and Evolution of Treatment
  257. [257]

    Voth C, Kapani N, Silveira CBD et al.. “The impact of comorbidities and surgical approach in incisional hernia development after minimally invasive cholecystectomy: a systematic review and meta-analysis of multivariate regression-adjusted studies.” Hernia : the journal of hernias and abdominal wall surgery (2025). PMID: 40266401 ↗

    L1SR_OBSCited in: History and Evolution of Treatment
  258. [258]

    Wiggins T, Markar SR, Mackenzie H et al.. “Evolution in the management of acute cholecystitis in the elderly: population-based cohort study.” Surgical endoscopy (2018). PMID: 30046948 ↗

    L2COHORTCited in: History and Evolution of Treatment, Special Populations & Pregnancy
  259. [259]

    Kaplan U, Handler C, Chazan B et al.. “The Bacteriology of Acute Cholecystitis: Comparison of Bile Cultures and Clinical Outcomes in Diabetic and Non-Diabetic Patients.” World journal of surgery (2021). PMID: 33860354 ↗

    L2OTHERCited in: History and Evolution of Treatment, Special Populations & Pregnancy
  260. [260]

    Reiss R, Nudelman I, Gutman C et al.. “Changing trends in surgery for acute cholecystitis.” World journal of surgery (1990). PMID: 2238655 ↗

    L2OTHERCited in: History and Evolution of Treatment
  261. [261]

    Lein HH, Huang CS. “Male gender: risk factor for severe symptomatic cholelithiasis.” World journal of surgery (2002). PMID: 12098053 ↗

    L2OTHERCited in: History and Evolution of Treatment
  262. [262]

    Kim J, Cho JN, Joo SH et al.. “Multivariable analysis of cholecystectomy after gastrectomy: laparoscopy is a feasible initial approach even in the presence of common bile duct stones or acute cholecystitis.” World journal of surgery (2012). PMID: 22270995 ↗

    L4OTHERCited in: History and Evolution of Treatment
  263. [263]

    Ibrahim S, Hean TK, Ho LS et al.. “Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy.” World journal of surgery (2006). PMID: 16927065 ↗

    L2OTHERCited in: History and Evolution of Treatment
  264. [264]

    Welsh S, Nassar AHM, Sallam M. “The incidence, operative difficulty and outcomes of staged versus index admission laparoscopic cholecystectomy and bile duct exploration for all comers: a review of 5750 patients.” Surgical endoscopy (2022). PMID: 35507063 ↗

    L2REVIEW_NARRATIVECited in: History and Evolution of Treatment
  265. [265]

    Parry SW, Pelias ME, Browder W. “Acalculous hypersensitivity cholecystitis: hypothesis of a new clinicopathologic entity.” Surgery (1988). PMID: 3187904 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  266. [266]

    Borges FK, Nenshi R, Serrano PE et al.. “Fast Track Pathway to Accelerated Cholecystectomy Versus Standard of Care for Acute Cholecystitis (FAST) pilot trial.” Canadian journal of surgery. Journal canadien de chirurgie (2025). PMID: 40216437 ↗

    L1RCTCited in: History and Evolution of Treatment
  267. [267]

    De Simone P, Mainente P, Bedin N. “Gallbladder melanoma mimicking acute acalculous cholecystitis.” Surgical endoscopy (2000). PMID: 11265063 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  268. [268]

    Dinçer B, Ömeroğlu S, Tufan AE et al.. “Evaluation of Risk Factors Leading to Conversion from Laparoscopic Cholecystectomy to Open Surgery: A Retrospective Controlled Study.” Journal of laparoendoscopic & advanced surgical techniques. Part A (2025). PMID: 39992726 ↗

    L2TRIAL_NONRANDOMCited in: History and Evolution of Treatment
  269. [269]

    Merriam LT, Kanaan SA, Dawes LG et al.. “Gangrenous cholecystitis: analysis of risk factors and experience with laparoscopic cholecystectomy.” Surgery (1999). PMID: 10520915 ↗

    L2OTHERCited in: History and Evolution of Treatment
  270. [270]

    Ko SW, Oh D, Song TJ. “Evolution of gallbladder drainage: a comprehensive review from percutaneous to endoscopic ultrasound-guided approaches.” Journal of gastroenterology (2026). PMID: 42029728 ↗

    L5REVIEW_NARRATIVECited in: History and Evolution of Treatment
  271. [271]

    Martínez Márquez RJ, Cienfuegos Alvear JA, Torres Monarrez AA et al.. “Acute cholecystitis and acute cholangitis: the radiologist's role in diagnosis and management.” Abdominal radiology (New York) (2025). PMID: 40728645 ↗

    L5REVIEW_NARRATIVECited in: History and Evolution of Treatment
  272. [272]

    Tu CW, Sun DP, Ong KH et al.. “Comparison of Surgical Outcomes of Emergent Laparoscopic Cholecystectomy for Acute Cholecystitis Between Attending Surgeons and Residents: A Retrospective Study in Single Medical Center.” Journal of laparoendoscopic & advanced surgical techniques. Part A (2025). PMID: 40080418 ↗

    L2COHORTCited in: History and Evolution of Treatment
  273. [273]

    Glasgow RE, Visser BC, Harris HW et al.. “Changing management of gallstone disease during pregnancy.” Surgical endoscopy (1998). PMID: 9502704 ↗

    L4OTHERCited in: History and Evolution of Treatment
  274. [274]

    Thapar VB, Thapar PM, Goel R et al.. “Evaluation of 30-day morbidity and mortality of laparoscopic cholecystectomy: a multicenter prospective observational Indian Association of Gastrointestinal Endoscopic Surgeons (IAGES) Study.” Surgical endoscopy (2022). PMID: 36357547 ↗

    L4OTHERCited in: History and Evolution of Treatment
  275. [275]

    Yin ZZ, Liu Y. “Guillain-Barré syndrome presenting with abdominal pain as the initial manifestation: a case report.” Frontiers in pain research (Lausanne, Switzerland) (2026). PMID: 42367234 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  276. [276]

    Yin ZZ, Liu Y, Pang SZ. “Herpes zoster as a diagnostic pitfall leading to an unwarranted cholecystectomy: a case report.” Frontiers in medicine (2026). PMID: 42292245 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  277. [277]

    Liu J, Zhan Y, Zhang Y et al.. “Case Report: A case study of geriatric acute cholecystitis complicated by coinfection with Shewanella putrefaciens and Enterococcus faecium.” Frontiers in medicine (2026). PMID: 41868205 ↗

    L4CASE_REPORTCited in: History and Evolution of Treatment
  278. [278]

    Fugazzola P, Carbonell-Morote S, Cobianchi L et al.. “Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study.” World journal of emergency surgery : WJES (2024). PMID: 38515141 ↗

    L2OTHERCited in: Prognosis and Natural History
  279. [279]

    Hantouli MN, Droullard DJ, Nash MG et al.. “Operative vs Nonoperative Management of Acute Cholecystitis During the Different Trimesters of Pregnancy.” JAMA surgery (2024). PMID: 37966823 ↗

    L3OTHERCited in: Prognosis and Natural History, Special Populations & Pregnancy
  280. [280]

    Fan H, Wang D, Liu H et al.. “Sarcopenia independently predicts acute cholecystitis in older patients with gallstones: a retrospective cohort study.” Frontiers in medicine (2026). PMID: 42051710 ↗

    L3COHORTCited in: Prognosis and Natural History
  281. [281]

    Ladhani HA, Posillico SE, Zosa BM et al.. “Efficiency of care and cost for common emergency general surgery conditions: Comparison by surgeon training and practice.” Surgery (2018). PMID: 30098814 ↗

    L3OTHERCited in: Prognosis and Natural History
  282. [282]

    Kesgin YM, Kaan AZ, Arslan M et al.. “Is there a difference in textbook outcomes of emergency cholecystectomy in older patients compared with younger patients?” World journal of emergency surgery : WJES (2025). PMID: 40721802 ↗

    L3OTHERCited in: Special Populations & Pregnancy
  283. [283]

    Faheem MSB, Najmi OEM, Farooq A et al.. “Trends in mortality related to benign gallbladder disease in the United States: A twenty - five year retrospective study.” Journal of the National Medical Association (2026). PMID: 42020236 ↗

    L2COHORTCited in: Special Populations & Pregnancy
  284. [284]

    Alhawiti T, Obeidat A, Sabbah BN et al.. “Outcomes and timing of laparoscopic cholecystectomy in gallstone disease: A single-center retrospective cohort study.” Medicine (2026). PMID: 42152339 ↗

    L3COHORTCited in: Special Populations & Pregnancy
  285. [285]

    Hane A, Yasuda Y, Matsuda Y et al.. “Acquired factor V deficiency in an elderly hemodialysis patient: a case report and literature review.” BMC nephrology (2026). PMID: 41654768 ↗

    L4CASE_REPORTCited in: Special Populations & Pregnancy
  286. [286]

    Cheng V, Matsushima K, Sandhu K et al.. “Surgical trends in the management of acute cholecystitis during pregnancy.” Surgical endoscopy (2020). PMID: 33025256 ↗

    L3OTHERCited in: Special Populations & Pregnancy
  287. [287]

    Höpner LK, Marschall E, Schindler P et al.. “Dermatological and gastrointestinal adverse reactions in ocrelizumab treated patients with multiple sclerosis: a case series.” Frontiers in immunology (2026). PMID: 41878428 ↗

    L4CASE_REPORTCited in: Special Populations & Pregnancy
  288. [288]

    Fugazzola P, Bianchi CM, Calabretto F et al.. “Intraoperative transcystic laparoscopic common bile duct stone clearance with SpyGlass™ discover during emergency and elective cholecystectomy: a single-center case series.” World journal of emergency surgery : WJES (2024). PMID: 38438899 ↗

    L4CASE_REPORTCited in: Prevention, Screening & Surveillance
  289. [289]

    Ridtitid W, Karuehardsuwan J, Faknak N et al.. “Endoscopic Gallbladder Stenting to Prevent Recurrent Cholecystitis in Deferred Cholecystectomy: A Randomized Trial.” Gastroenterology (2024). PMID: 38360274 ↗

    L1RCTCited in: Prevention, Screening & Surveillance
  290. [290]

    Selin D, Oskarsson V, Maret-Ouda J et al.. “Cholecystectomy vs Endoscopic Retrograde Cholangiopancreatography or No Intervention After Gallstone-Related Acute Pancreatitis.” JAMA surgery (2026). PMID: 42340741 ↗

    L3OTHERCited in: Prevention, Screening & Surveillance
  291. [291]

    Harada K, Miyamoto K, Matsumoto K et al.. “Long-Term Outcomes of Endoscopic Ultrasound-Guided Gallbladder Drainage for Acute Cholecystitis in Non-Surgical Candidates: A Multicenter Retrospective Study.” Journal of clinical medicine (2026). PMID: 42194584 ↗

    L3COHORTCited in: Prevention, Screening & Surveillance
  292. [292]

    Hui YJ, Chen AZL, Pham H et al.. “Predictors of failure of conservative management of cholecystitis: a systematic review of the literature.” ANZ journal of surgery (2024). PMID: 39686654 ↗

    L2SR_OBSCited in: Prevention, Screening & Surveillance
  293. [293]

    Salama A, Calpin GG, Fuller R et al.. “Clinical predictors of recurrent cholecystitis in non-operative management: A systematic review & meta-analysis.” The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland (2024). PMID: 39542810 ↗

    L2SR_OBSCited in: Prevention, Screening & Surveillance
  294. [294]

    Koya Y, Shibata M, Maruno Y et al.. “Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management: A propensity score-matched cohort study.” Hepatobiliary & pancreatic diseases international : HBPD INT (2023). PMID: 37516589 ↗

    L3COHORTCited in: Prevention, Screening & Surveillance
  295. [295]

    Cui ML, Cho JH, Kim TN. “Long-term follow-up study of gallbladder in situ after endoscopic common duct stone removal in Korean patients.” Surgical endoscopy (2012). PMID: 23242488 ↗

    L3OTHERCited in: Prevention, Screening & Surveillance
  296. [296]

    Gallego Vela A, Martínez Baena D, Lorente Herce JM et al.. “Laparoscopic common bile duct exploration for choledocholithiasis on an emergency setting.” Surgical endoscopy (2024). PMID: 39738906 ↗

    L4OTHERCited in: Prevention, Screening & Surveillance
  297. [297]

    Jang WS, Lim JU, Joo KR et al.. “Outcome of conservative percutaneous cholecystostomy in high-risk patients with acute cholecystitis and risk factors leading to surgery.” Surgical endoscopy (2014). PMID: 25487543 ↗

    L4OTHERCited in: Prevention, Screening & Surveillance
  298. [298]

    Rebecchi F, Ugliono E, Palagi S et al.. “Robotic "Double Loop" Roux-en-Y gastric bypass reduces the risk of postoperative internal hernias: a prospective observational study.” Surgical endoscopy (2020). PMID: 32857240 ↗

    L4OTHERCited in: Prevention, Screening & Surveillance
  299. [299]

    Bergeron E, Doyon T, Manière T et al.. “Delay for cholecystectomy after common bile duct clearance with ERCP is just running after recurrent biliary event.” Surgical endoscopy (2023). PMID: 37726412 ↗

    L3OTHERCited in: Prevention, Screening & Surveillance

Revision History

All updates applied to this page

Loading revisions…