Today's treatment of cholelithiasis: laparoscopic surgery

The speed at which laparoscopic biliary tract surgery has been introduced to such a large number of surgeons is without precedent in modern surgical history. At least 4 factors work together to explain such a rapid success: 1) Laparoscopic cholecystectomy removes the diseased gallbladder and ensures permanent cure; 2) Laparoscopic approach allows a telescopic vision and dissections are very precise; 3) Laparoscopic cholecystectomy allows minimal wound pain with complete resolution within a few days, a short hospital stay and the ability of many patients to return to work within a week of operation; 4) There are economic advantages to the patient, his community and the healthcare provider. The procedure proved to be as safe and feasible to use as conventional surgery. Obviously adequate training and credentialing are important processes to faster good patient outcomes. There are some contraindications to laparoscopic surgery, the most part of them are depending upon the experience of the surgeon. The successful application of therapeutic laparoscopy changed the diagnostic approach to lithiasic biliary disease. Whereas the most popular method of documenting gallbladder abnormalities before performing conventional surgery is ultrasonography, most surgeons who have embraced laparoscopic surgery argue for routine cholangiography because of the necessity to document duct anatomy besides minimizing the incidence of retained GBDS.