Cholelithiasis: The term cholelithiasis refers to the presence of stones, biliary sludge, or a combination of both within the gallbladder lumen. Causes of cholelithiasis may be dietary, such as consumption of high-fat foods, obesity, or conversely, rapid weight loss, or related to other conditions such as the use of certain medications, gallbladder dyskinesia, and diseases like diabetes mellitus, inflammatory bowel disease, and hematologic disorders. Additionally, independent factors such as female sex, pregnancy, and age over 40 predispose individuals to cholelithiasis.

The main complications of cholelithiasis include acute cholecystitis, acute cholangitis, acute pancreatitis, abdominal or epigastric pain characterized as biliary colic, and, in rare cases, a predisposition to gallbladder cancer.

Gallbladder Polyps: These are small protrusions that develop inside the gallbladder, affecting less than 10% of the general population. They are usually cholesterol polyps but can also be inflammatory or adenomatous, with adenomatous polyps considered the most dangerous due to potential malignant transformation. Most are caused by cholesterol deposition, may accompany hereditary disorders, or are associated with chronic gallbladder inflammation. In the majority of cases, they are asymptomatic.

Management: Managing gallbladder diseases today is a significant challenge, primarily because it is essential to distinguish which patients should undergo surgery and which should not.

Patients with cholelithiasis are classified as symptomatic or asymptomatic. Symptomatic patients should undergo cholecystectomy, whereas for asymptomatic patients, clear criteria exist to determine who will benefit from surgery. Similarly, the management of gallbladder polyps is guided by specific rules and clinical guidelines.

Laparoscopic Cholecystectomy: Laparoscopic cholecystectomy is the procedure of choice for the treatment of gallbladder diseases. It is a minimally invasive technique that must be performed by experienced surgeons, as it is not free of complications. Specific rules, such as performing the Critical View of Safety and the selective use of drains, should always be followed for the patient’s benefit. Laparoscopic cholecystectomy offers minimal postoperative pain, rapid mobilization and return to work, and a short hospital stay.