TY - CHAP M1 - Book, Section TI - Cholecystectomy, Laparoscopic A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. PY - 2022 T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - The indications for laparoscopic cholecystectomy are similar to those for open cholecystectomy. These include, but are not limited to, symptomatic cholelithiasis, acute calculus and acalculous cholecystitis, gallstone pancreatitis, biliary dyskinesia, and gallbladder masses and polyps that are concerning for malignancies. Cholecystectomy for mild gallstone pancreatitis should be performed during the initial admission for pancreatitis and deferred for several weeks in patients with severe pancreatitis. Contraindications to laparoscopic cholecystectomy include small bowel obstruction secondary to gallstone ileus (which would mandate an open surgical approach), coagulopathy, and medical comorbidities prohibiting surgery. Relative contraindications to a laparoscopic approach, primarily previous intra-abdominal surgery resulting in adhesions and severe cholecystitis, are decreasing as surgeon experience with minimally invasive surgery increases. Factors associated with increased surgical risk include older age, specific medical comorbidities such as diabetes mellitus, male sex, cirrhosis with or without portal hypertension, and acute gangrenous cholecystitis. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/18 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187822134 ER -