Indications of Laparoscopic Cholecystectomy Based on Preoperative Imaging Findings

Yoshitaka Wakizaka¹⁾²⁾, Syuichi Sano¹⁾, Yoshimi Nakanishi¹⁾, Yoshinobu Koike¹⁾²⁾, Susumu Ozaki¹⁾, Rikizo Iwanaga¹⁾, Junichi Uchino²⁾

¹⁾Department of Surgery, Sapporo City General Hospital
²⁾First Department of Surgery, Hokkaido University School of Medicine

I studied the indications for laparoscopic cholecystectomy (LC) and values of preoperative imaging findings in 82 patients who underwent preoperative imaging diagnostic tests (abdominal echogram, abdominal CAT scan, ERCP). I analyzed mainly patients who were considered to be indicated for LC but whose gallbladders could be removed by open laparotomy, or whose gallbladders were removed by open laparotomy but were considered indicated for LC from retrospective study. I found the following results: 1) LC can be easily performed in patients with a history of severe acute cholecystitis if they have no findings of a thickened wall or negative gallbladder signs. 2) Abdominal echogram and CAT scan were the best preoperative imaging tests for determining the gallbladder's state, especially for obstruction of the cystic duct. These results are important today when the operative indications of LC are extremely indefinite because of the accumulation of operative experience and technological improvements.

Key words
laparoscopic cholecystectomy, operative indication, ERCP, abdominal echogram, acute cholecystitis

Reprint requests
Yoshitaka Wakizaka First Department of Surgery, Hokkaido University School of Medicine
Kita-l5-jo Nishi-7-chome, Kita-ku, Sapporo, 060 JAPAN

Accepted
November 1, 1993

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