@article{MAKHILLSJ20083319620,
    title = {Surgical Considerations for the Laparoscopic Management of Special Diseases of the Gallbladder},
    journal = {Surgery Journal},
    volume = {3},
    number = {3},
    pages = {49-54},
    year = {2008},
    issn = {1816-3211},
    doi = {sjour.2008.49.54},
    url = {https://makhillpublications.co/view-article.php?issn=1816-3211&doi=sjour.2008.49.54},
    author = {Stefan Farke,Boris Jansen-Winkeln,Christian Franke,Andreas Paech,Albert Jagle,Ernst Kraas and},
    keywords = {Laparoscopy,acute cholecystitis,gallbladder carcinoma,surgical,symptomatic gall stones},
    abstract = {Laparoscopic surgery is the gold standard for the treatment of symptomatic gall stones. However, it remains unclear when an open surgical or a laparoscopic approach is more appropriate in difficult acute or rare cases. The tactical concept in the decision making is presented. Between June 1990 and December 2001, 7303 patients underwent a cholecystectomy, 6942 operations were completed minimally invasive. There were 990 (13.6%) with acute cholecystitis and 47 (0,6%) with malignant disease of the gallbladder. A conversion was required in 1.66% of all operations and in 10.61% for acute cholecystitis. The total rate of complications was 4.2% without significant differences between acute or chronic cholecystitis. In the study period  there  were  47 patients with malignancies of the gallbladder. The 5-years, survival rate depended on the stage of the tumour and the operation carried out. The clinical suspicion of malignancy is usually associated with an advanced stage. In these cases open laparotomy is the access of choice. Early tumours are frequently incidentalomas that laparoscopic surgery alone can be sufficient to cure. In summary, laparoscopic resection can be considered safe even for difficult indications. A standardised surgical approach and an experienced team is most important.}
    }