Laparoscopic cholecystectomy.

Laparoscopic cholecystectomy has emerged in the last 2 years as a unique procedure that offers the long-term advantages of open cholecystectomy without much of the short-term morbidity. Importantly, when compared with non-surgical approaches to symptomatic gallstones, it is suitable for virtually all patients rather than a highly-selected group as in the case of oral bile salt dissolution therapy or extracorporeal lithotripsy. Furthermore, it obviates the high recurrence rate seen with these techniques. Complications including bleeding and ductal injury appear to occur at a slightly higher rate than with traditional open cholecystectomy, but most surgeons who have had experience with the procedure predict that these complications will become rarer as more experience is gained. We may indeed be witnessing the first major successful challenge to traditional surgical management of symptomatic gallstone disease in 100 years.