Contraindications
Patients may be contraindicated to have cholecystectomy for multiple reasons which are evaluated by their surgeon. Cholecystectomy is postponed in case of temporary contraindications whereas patients with permanent contraindications are switched to a line of treatment other than surgery. Contraindications are divided into absolute contraindication (mustn’t be done regardless of any indications) and relative contraindications (non-favorable unless its benefits overshadow its risks)
Absolute contraindications include uncontrolled coagulopathy. Coagulopathy is a medical disorder in which a patient’s blood can’t stop bleeding on its own by making clots properly. Patients with uncontrolled coagulopathy tend to bleed profusely, therefore they would be at a life-threatening risk if they underwent open cholecystectomy. Intolerance for general anesthesia is also considered an absolute contraindication for surgery.
Relative contraindications are subjected to surgeons’ evaluation and assessment. It is critically important to avoid putting a patient’s life in danger, so doctors carefully examine patients before surgeries especially those with relative contraindications. Acute cholecystitis is the most common relative contraindication for cholecystectomy. Surgeons prefer to wait until the inflammation subsides by medications before doing the surgery to avoid gallbladder rupture. Terminal gall bladder tumor that has spread to the surrounding organs is a relative contraindication for cholecystectomy because there would be no use of surgeries or medications other than palliative treatment. A gallbladder abscess is considered as a relative contraindication for cholecystectomy as it may cause empyema and sepsis so it should first be treated with antibiotics or drained.
