Laparoscopic cholecystectomy in a female patient with multiple comorbidities (ASA II): A case report

Laparoscopic cholecystectomy is the standard surgical approach for symptomatic gallbladder disease and remains among the most frequently performed operations worldwide. Common indications include symptomatic cholelithiasis, biliary dyskinesia, acute cholecystitis, gallstone-related complications, and gallbladder polyps. Compared with open cholecystectomy, the laparoscopic technique offers well-established advantages, including smaller incisions, less postoperative pain, shorter length of hospital stay, and earlier return to usual activities and work. Acute cholecystitis is a leading cause of acute abdomen and is often reported as the second most common surgical emergency after appendicitis.
We report the case of a 64-year-old woman with multiple comorbidities and known cholelithiasis diagnosed six months earlier without definitive treatment. She presented with 8 hours of severe epigastric pain radiating to the right upper quadrant (visual analogue scale [VAS] 10/10). Imaging and laboratory assessment supported a diagnosis of acute calculous cholecystitis with concomitant choledocholithiasis. The patient underwent laparoscopic cholecystectomy with intraoperative gallbladder perforation and spillage, managed with irrigation and retrieval of gallstones, followed by antibiotic therapy and favorable postoperative evolution.