Surgery is virtually never required in the management of cholera and plays no role in treating the infection itself. The disease kills through the rapid loss of fluid and electrolytes, leading to circulatory collapse and organ failure. Rehydration therapy—whether oral or intravenous—is prioritized because it directly and immediately addresses this lethal mechanism by replenishing the lost water and salts. This simple intervention is highly effective, saving over 99% of patients.
In extremely rare circumstances, surgery might be considered, but not for the cholera infection per se. For instance, if the intense purging were to cause a mechanical complication like an intestinal perforation, surgical repair would be necessary. However, this is a complication of the symptom (profuse diarrhea) rather than a standard part of the disease process. Therefore, the focus remains overwhelmingly on medical, not surgical, management, as rehydration is the definitive, life-saving treatment for the core pathology of cholera.