What are the indications for laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is the gold-standard surgical treatment for symptomatic gallstone disease and several other gallbladder-related conditions. Its primary indications include symptomatic cholelithiasis—characterized by recurrent biliary colic, typically presenting as episodic right upper quadrant or epigastric pain after fatty meals—along with complications such as acute cholecystitis, gallstone pancreatitis, and choledocholithiasis (when associated with common bile duct stones confirmed by imaging or laboratory findings). Other accepted indications encompass chronic calculous or acalculous cholecystitis with documented biliary dyskinesia (e.g., gallbladder ejection fraction <35% on hepatobiliary iminodiacetic acid [HIDA] scan), porcelain gallbladder (due to markedly increased risk of gallbladder carcinoma), and select cases of gallbladder polyps ≥10 mm in diameter or those exhibiting growth over time. Relative indications may include asymptomatic gallstones in patients undergoing bariatric surgery or those with sickle cell disease, where prophylactic removal mitigates future risks. Contraindications are primarily absolute in cases of uncorrectable coagulopathy, advanced pregnancy (particularly third trimester), or severe cardiopulmonary compromise precluding safe pneumoperitoneum and general anesthesia.