CHOLECYSTITIS IN THE EMERGENCY DEPARTMENT: AN INTEGRATED CLINICAL AND SURGICAL EVALUATION

Abstract

Introduction: Cholecystitis, inflammation of the gallbladder, is often a challenging clinical condition, especially in emergency settings. Signs and symptoms range from severe abdominal pain to nausea and fever, making accurate diagnosis and effective treatment crucial to prevent serious complications, such as gallbladder perforation. An integrated approach between clinical evaluation and surgical intervention has become an essential component in the management of this pathology, with emergency situations demanding rapid and well-founded decisions. Understanding the risk factors, clinical manifestations, and treatment protocols is essential to optimize results. Objective: To analyze clinical and surgical approaches in the management of cholecystitis in emergency situations, seeking to identify patterns of efficacy and safety in the available treatments. Methodology: The review was performed according to the PRISMA checklist, using the PubMed, Scielo, and Web of Science databases. Five descriptors were applied: "cholecystitis," "urgency," "clinical evaluation," "surgical intervention," and "treatment." The inclusion criteria consisted of articles that addressed cholecystitis in the context of emergency care, published in the last ten years, and that presented relevant clinical data. The exclusion criteria included studies focusing on unrelated pathologies, old reviews or articles with reduced sample sizes. Results: The review highlighted that acute cholecystitis represented one of the most common causes of abdominal pain in emergency care. The main topics addressed the importance of early diagnosis, the efficacy of conservative versus surgical treatments, and the complication rates associated with laparoscopic surgery compared to open surgery. It was observed that the laparoscopic approach provided shorter recovery time and lower complication rates. Conclusion: In summary, integrated clinical and surgical evaluation in cholecystitis in emergency situations proved to be vital for the effectiveness of treatment. The analysis of the literature emphasized the need for a well-structured protocol that considers the individual characteristics of patients and the specificities of the condition, contributing to better clinical outcomes and reduced complications.