Laparoscopic Cholecystectomy: From Basic Principles to Management of Complications - A Review

Background: The current gold standard for treating gallbladder disease symptoms is laparoscopic cholecystectomy (LC), including cholelithiasis and its complications. Since its first introduction in the late 1980s, LC has rapidly replaced open cholecystectomy due to advantages such as reduced postoperative pain, shorter hospital stay, earlier return to normal activities, and improved cosmetic outcomes. Despite its minimally invasive nature, LC may still present technical difficulties in cases of severe inflammation, anatomic variations, dense adhesions, or distorted biliary anatomy, all of which increase the risk of bile duct injury. Continuous advancements in surgical technique and perioperative care continue to improve safety and patient outcomes. Objective: To review the indications, contraindications, anatomical landmarks, operative considerations, and complications associated with laparoscopic cholecystectomy, while outlining evidence-based approaches for improving procedural safety and clinical outcomes. Conclusion: Laparoscopic cholecystectomy remains a safe and highly effective standard procedure for managing gallbladder disease. Although generally straightforward, difficult cases require careful anatomical identification, adherence to the critical view of safety, and early conversion to open surgery when necessary. Advances in imaging, operative techniques, and structured surgical training continue to enhance the safety profile and overall success of LC.