Update on laparoscopic cholecystectomy, including a clinical pathway.

Laparoscopic cholecystectomy is a minimally invasive procedure in which the gallbladder is removed. Patients with symptomatic gallstones or biliary dyskinesis are eligible for this procedure. No specific contraindications exist except for poor surgical risk factors. The rate of conversion to an open technique is increased in patients with acute disease, pancreatitis, bleeding disorders, unusual anatomy, and prior upper abdominal surgery. Complications occur even with experienced laparoscopists, and the important technical aspects of surgery have been identified. The length of the hospital stay and postoperative recovery time is markedly shortened compared with that of standard cholecystectomy. This procedure offers sufficient advantages to patients that it has become the standard of practice in most cases.