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Conditions associated with a difficult cholecystectomy

Conditions associated with a difficult cholecystectomy
Difficulty in operative access and exposure:
  • Previous upper abdominal surgery
  • Obesity
Inflammatory processes involving the gallbladder:
  • Severe chronic cholecystitis
    • Older age, male sex
    • Multiple prior attacks of biliary colic
    • Thickened gallbladder wall on ultrasound
    • Shrunken, contracted gallbladder on imaging
  • Acute cholecystitis
    • Gangrenous cholecystitis
    • Emphysematous cholecystitis
    • Perforated gallbladder
  • Mirizzi's syndrome
Other conditions:
  • Cirrhosis
A difficult cholecystectomy may be predicted preoperatively based on these patient characteristics, based on which the surgeon should take steps to ensure the safe performance of the procedure.
Graphic 113919 Version 1.0

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