Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10642
Revised: March 28, 2014
Accepted: May 28, 2014
Published online: August 14, 2014
Acute acalculous cholecystitis (AAC) is a rare complication of gastric surgery. The most commonly accepted concepts regarding its pathogenesis are bile stasis, sepsis and ischemia, but it has not been well described how to identify and manage this disease in the early stage. We report three cases of AAC in elderly patients immediately after gastric surgery, which were treated with three different strategies. One patient died 42 d after emergency cholecystectomy, and the other two finally recovered through timely cholecystostomy and percutaneous transhepatic gallbladder drainage, respectively. These cases informed us of the value of early diagnosis and proper treatment for perioperative AAC after gastric surgery. We further reviewed reported cases of AAC immediately after gastric operation, which may expand our knowledge of this disease.
Core tip: Acute acalculous cholecystitis (AAC) after gastric surgery is not common but it progresses rapidly once it occurs. Manifestations of AAC after gastric surgery are usually atypical and cannot be easily distinguished from other complications, which leads to delayed diagnosis and treatment and even death. Here, we report three such cases and review the literature, to give more attention to this disease. Early diagnosis and prompt surgical intervention are the keys to successful treatment.