Laparoscopic management of gallstone disease.

The development of laparoscopic cholecystectomy has had a major impact on the management of patients with biliary tract disease. The evidence today suggests that the procedure is safe, effective, and has special advantages over open cholecystectomy in terms of patient discomfort and postoperative convalescence. Laparoscopic cholecystectomy has become the treatment of choice for patients with symptomatic cholelithiasis. However, the availability of this minimally invasive approach to gallstones should not alter the indications for operation. Minimally invasive techniques are increasingly being adapted to the management of patients with other biliary tract problems, including acute cholecystitis and choledocholithiasis. Continued surveillance of outcomes is warranted to ensure that these procedures are being applied safely and appropriately.