[Postoperative and stress-induced alithiasic cholecystitis. Report on 25 cases seen between 1960 and 1980 (author's transl)].

Acute alithiasic cholecystitis developed in 25 patients during the course of surgical, traumatic, or infective aggressions. Diagnosis was usually by ultrasonography, which proved to be the best means for exploration of the accessory biliary pathways during the postoperative period. If not, in the absence of a diagnosis, the lesion was usually discovered during a repeat operation because of sepsis. Findings during operation are frequently difficult to interpret. When confronted with a large but only slightly oedematous gallbladder, and when the rest of the abdomen appears normal, this should be sufficient to establish the diagnosis and to perform a cholecystectomy. Prevention of such accidents requires ultrasonographic surveillance of the gallbladder in high risk patients. The value of cholecystokinin is discussed.