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Zentralbl Chir 2018; 143(04): 392-399
DOI: 10.1055/a-0631-9463
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Die akute Cholezystitis

Acute Cholecystitis
Greta Burmeister
Klinik für Allgemeine-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
,
Sebastian Hinz
Klinik für Allgemeine-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
,
Clemens Schafmayer
Klinik für Allgemeine-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
› Author Affiliations
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Publication History

Publication Date:
22 August 2018 (online)

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Zusammenfassung

Die akute Cholezystitis ist eine Inflammation der Gallenblase und wird zu ca. 90% der Fälle durch eine Cholelithiasis getriggert. Gallensteinassoziierte Erkrankungen gehören zu den teuersten im Bereich der Gastroenterologie und haben somit eine hohe volkswirtschaftliche Relevanz. Der Entstehungsprozess von Gallensteinen ist multifaktoriell. Mit steigendem Alter steigt das Risiko für das Gallensteinleiden. Insbesondere die kohlenhydrat- und fettreiche Ernährung sowie der Mangel an körperlicher Bewegung in der westlichen Welt sind an der Entstehung von Gallensteinen beteiligt. Als weiterer wichtiger Risikofaktor konnten genetische Varianten in Cholesterintransportern identifiziert werden. Die Diagnose erfolgt durch die Kombination aus Anamnese, körperlichem Untersuchungsbefund, abdomineller Sonografie sowie laborchemischen Infektparametern. Typisch sind kolikartige Schmerzen im rechten Oberbauch, die länger als 6 Stunden anhalten, Fieber bzw. Leukozytose und ein Gallenblasenwandödem im Ultraschall in Kombination mit einem positiven Murphy-Zeichen. Die Therapie der Wahl stellt die frühzeitige laparoskopische Cholezystektomie dar.

Abstract

Acute cholecystitis is inflammation of the gallbladder and is triggered by cholelithiasis in about 90% of cases. Gallstone-associated diseases are among the most expensive in the field of gastroenterology and are therefore of great economic importance. Development of gallstones is multifactorial. The risk of gallstone disease increases with age. In particular, the carbohydrate- and fat-rich diet and the lack of physical activity in the Western world are involved in the formation of gallstones. Another important risk factor is genetic variants in cholesterol transporters. Diagnosis is based on the combination of the medical history, the physical examination, abdominal ultrasound and infection parameters in clinical chemistry. Typical symptoms include colic-like upper abdominal pain lasting more than six hours, fever or leukocytosis, and ultrasound gallbladder wall oedema in combination with a positive Murphy sign. The treatment of choice is early laparoscopic cholecystectomy.

Schlüsselwörter

akute Cholezystitis - laparoskopische Chirurgie - Gallensteinleiden

Key words

acute cholecystitis - laparoscopic surgery - gallstones
 

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