2018 Volume 32 Issue 1 Pages 51-61
Evidence-based clinical practice guidelines for cholelithiasis 2016 was published by the Japanese Society of Gastroenterology, and TG13: Updated Tokyo guidelines for Management of Acute Cholangitis and Acute Cholecystitis was published in Journal of Hepato-Biliary-Pancreatic Sciences, are very useful for treatment of cholelithiasis. Based on their guidelines, we will explain some important points in surgical treatment of cholelithiasis.
When the patient with cholecystolithiasis undergo laparoscopic cholecystectomy, 1) check the biliary anatomy before the surgery, 2) to confirm the critical view of safety, 3) to consider the timing of convert to open surgery or subtotal cholecystectomy in severe inflammation, are important. To learn well the skill of laparoscopic or open choledocholithotomy are necessary for biliary surgeon. Take care of the occurrence of biliary malignancy and the recurrence of gallstone over the long term for follow-up of the patients with hepatolithiasis.
Because cholelithiasis causes acute cholecystitis or cholangitis, it is important to develop a strategy considering concomitant inflammation status.
