Contraindications of laparoscopic cholecystectomy is:
**Core Concept**
Laparoscopic cholecystectomy is a minimally invasive surgical procedure for the removal of the gallbladder. Contraindications to this procedure are conditions that increase the risk of complications or make it technically difficult to perform safely. These contraindications can be broadly categorized into absolute and relative.
**Why the Correct Answer is Right**
Absolute contraindications to laparoscopic cholecystectomy include conditions that make the procedure technically impossible or increase the risk of severe complications. These include **severe inflammatory bowel disease**, which can lead to adhesions and make dissection difficult, and **severe adhesions** from previous abdominal surgeries, which can increase the risk of bowel injury during dissection.
**Why Each Wrong Option is Incorrect**
* **Option A:** Liver cirrhosis is not an absolute contraindication to laparoscopic cholecystectomy, but it may increase the risk of complications due to coagulopathy and portal hypertension. However, it is not a contraindication per se.
* **Option B:** Obesity is not an absolute contraindication to laparoscopic cholecystectomy, although it may make the procedure more challenging. Laparoscopic surgery can be performed safely in obese patients with proper patient selection and surgical technique.
* **Option C:** Cardiac disease is not an absolute contraindication to laparoscopic cholecystectomy, although it may increase the risk of complications due to anesthesia and surgical stress. However, it is not a contraindication per se.
**Clinical Pearl / High-Yield Fact**
Absolute contraindications to laparoscopic cholecystectomy include conditions that make the procedure technically impossible or increase the risk of severe complications. These include severe inflammatory bowel disease and severe adhesions from previous abdominal surgeries.
**Correct Answer: D. Severe inflammatory bowel disease.**