Laparoscopic Cholecystectomy

Excerpt

Laparoscopic cholecystectomy is a minimally invasive surgical procedure for removal of a diseased gallbladder. This technique essentially has replaced the open technique for routine cholecystectomies since the early 1990s. At this time, laparoscopic cholecystectomy is indicated for the treatment of cholecystitis (acute/chronic), symptomatic cholelithiasis, biliary dyskinesia, acalculous cholecystitis, gallstone pancreatitis, and gallbladder masses/polyps. These indications are the same for an open cholecystectomy. Cases of gallbladder cancers are usually best treated with open cholecystectomy. Approximately 20 million people in the United States have gallstones. Of these people, there are approximately 300,000 cholecystectomies performed annually. Ten percent to 15% of the population has asymptomatic gallstones. Of these, 20% are symptomatic (biliary colic). Of the 20% who are symptomatic approximately 1% to 4% will manifest complications (acute cholecystitis, gallstone pancreatitis, choledocholithiasis, gallstone ileus). The incidence of gallstones increases with an increase in age, with females more likely to form gallstones than males. Age 50 to 65 approximately 20% of women and 5% of men have gallstones. Overall, 75% of gallstones are composed of cholesterol, and the other 25% are pigmented. Despite the composition of gallstones the clinical signs and symptoms are the same.

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