Ubi pus, ibi evacua
Which of the following is true about acute cholecystitis diagnosis and management?
The absence of sonographic evidence of cholecystitis should steer clinical evaluation away from the diagnosis. The Fukuoka guidelines present a reliable framework to establish the diagnosis and severity grading of acute cholecystitis. In patients with cholecystitis and choledocholithiasis, a bridging therapy transpapillary gallbladder drainage worsens postsurgical outcomes for future surgical candidates. When endoscopic therapy is favored for cholecystitis, transgastric lumen-apposing metal stent drainage of a hot gallbladder is less favored than the transduodenal approach given the higher risk of stent migration.
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