Preoperative Optimization for Elective Cholecystectomy
The key to performing a safe laparoscopic cholecystectomy in the elective setting is a thorough preoperative assessment of the patient. There are certain patient conditions and diseases that may be predictive of a difficult operation, and these need to be considered before entering the operating room. One must know when to operate and when not to operate and to be able to consider nonoperative management strategies when appropriate. Understanding the alternatives to immediate cholecystectomy and when to apply them is critical. Finally, knowing when to seek guidance from others is important, especially in difficult situations when there is concern or doubt of the safety in performing a cholecystectomy.
KeywordsPreoperative assessment Laparoscopic cholecystectomy Cholecystostomy tube Difficult gallbladder Gallbladder polyp Acute cholecystitis Morbid obesity Mirizzi’s syndrome
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