indications
Last reviewed 01/2018
Laparoscopic cholecystectomy is recommended in the patient with symptomatic cholelithiasis who has none of the following contraindications:
- a thickened, non-contractile, small-volumed gallbladder; fibrosis and adhesions make excision difficult
- acute gallstone disease
- uncorrectable bleeding disorders or present haemorrhage
- advanced liver disease
- obesity: view of operative field is better than with open procedures
- significant abdominal scarring and adhesions from previous surgery
- abdominal wall infection
- a significant general anaesthetic risk
It is becoming clear that some of these risks factors are less important than was originally thought, e.g. laparoscopic cholecystectomy is now advocated for symptomatic cholelithiasis in pregnancy - this was previously contraindicated.