Gallstones generally do not require surgical treatment in the absence of symptoms, but if comorbidities occur or the condition turns serious, surgical removal of the gallbladder should be considered to avoid life-threatening conditions.
1.Indications for cholecystectomy
For gallbladder stones with symptoms and/or complications, cholecystectomy should be performed promptly. For asymptomatic gallbladder stones, it is generally believed that immediate cholecystectomy is not needed, but only observation and follow-up.
(1) Oral cholecystography gallbladder is not visualized;
(2) Stones more than 2-3 cm in diameter;
(3) combined with porcelain gallbladder;
(4) Combined diabetes mellitus when it is under control;
(5) Those with cardiopulmonary dysfunction. In the latter two cases, once acute attack or complications occur and emergency surgery is forced, the risk is much greater than elective surgery.
2. Contraindications to laparoscopic cholecystectomy
Laparoscopic surgery is an emerging technology that was gradually developed in the late 20th century. It also has contraindications like other surgeries.
(1) Those who are suspected of having gallbladder cancer;
(2) Combination of primary bile duct stones and biliary strictures;
(3) cirrhosis of the liver with portal hypertension;
(4) Those with disorders of coagulation mechanism;
(5) severe intra-abdominal infection and peritonitis;
(6) Pregnancy combined with gallstones;
(7) Mirizzi syndrome;
(8) Combined bile-intestinal fistula;
(9) Severe cardiopulmonary dysfunction and inability to tolerate general anesthesia with tracheal intubation;
(10) Extensive intra-abdominal adhesions;