الفهرس 
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Abstract
Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and in developed countries many are performed laparoscopically. As an example, 90 percent of cholecystectomies in the United States are performed laparoscopically Laparoscopic cholecystectomy is considered the ”gold standard” for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmesis, shorter hospital stays and disability from work than open cholecystectomy However, the overall serious complication rate in laparoscopic cholecystectomy remains higher than that seen in open cholecystectomy Laparoscopic cholecystectomy has replaced open surgery in the treatment of symptomatic cholecystolithiasis While Laparoscopic cholecystectomy offers the patient several advantages of minimal invasive surgery, the spectrum of complications in gallstone surgery has changed compared to open procedure. Laparoscopy-related complications such as bile duct injury (BDI) tend to be complex being more proximal and often associated with concomitant vascular injury This along with injuries during access into peritoneal cavity such as bowel and major retroperitoneal vascular injury has raised the morbidity to 2.9% The spectrum of complications has also changed due to the involvement of new instruments such as stapling device and energized instruments. Related complications like migrating clips or spillage of gallstone into peritoneal cavity were completely unknown in open surgery Although laparoscopic cholecystectomy has resulted in an increase in bile duct injuries, some have proposed an eventual swing of the pendulum so that open cholecystectomy might become associated with a greater chance of duct complications. This would be the result of a combination of factors, including selection bias and surgeon training. For example, the most profoundly inflamed gallbladders (those with the greatest risk of duct injury) are those that will be converted to open operations. In the near future, these operations will be performed by surgeons who have limited experience in complex biliary (and other open) operations, as the seasoned biliary surgeons leave practice. However, this scenario has yet to come to fruition and bile duct injuries are still twice as likely to develop after laparoscopic than open cholecystectomy.