title: Laparoscopic approach to cholecystectomy.
abstract: Laparoscopic cholecystectomy is a combined endoscopic-operative technique for removal of the gallbladder. Patients with symptomatic gallstones are candidates for this procedure. Current absolute contraindications include pregnancy, acute cholangitis, peritonitis or abdominal sepsis, and a major bleeding disorder. Safe use of the procedure requires specific training and subsequent animal and proctored clinical experience. The technique is guided by video-endoscopy, and is performed through four cannulas/ports. Potential complications include bleeding, injury to the common bile duct, trocar injury to the bowel, and spillage of bile and/or stones. The length of hospital stay and postoperative recovery are significantly shortened compared to standard cholecystectomy. Patients appear to prefer this procedure over lithotripsy or dissolution because the gallbladder and stones are removed and additional or continued treatment is not necessary. This procedure offers notable advantages to the patient, and is becoming a standard procedure for qualified general surgeons.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: M A
authors.initials: MA
authors.lastname: Talamini
authors.forename: T R
authors.initials: TR
authors.lastname: Gadacz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000075202:Contraindications; D003406:Credentialing; D013502:General Surgery / Q000193:education; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D011182:Postoperative Care; D013523:Surgical Equipment