**Core Concept**
Chronic calculous cholecystitis is a condition where the gallbladder is inflamed due to the presence of gallstones, leading to symptoms like right upper quadrant abdominal pain. The condition is often treated surgically to remove the inflamed gallbladder. However, the choice of surgical approach depends on various factors, including the presence of common bile duct stones and liver function tests.
**Why the Correct Answer is Right**
In this scenario, the patient's liver function tests are within normal limits, and the common bile duct is not dilated, suggesting that there are no common bile duct stones. Therefore, the procedure of choice is a straightforward laparoscopic cholecystectomy, which involves removing the gallbladder through small incisions in the abdomen. This approach is less invasive and has a faster recovery time compared to open surgery. Laparoscopic cholecystectomy is a widely accepted treatment for chronic calculous cholecystitis without common bile duct stones.
**Why Each Wrong Option is Incorrect**
**Option A:** Open choledocholithotomy followed by laparoscopic cholecystectomy would be a more invasive approach than necessary, given the absence of common bile duct stones.
**Option B:** ERCP + choledocholithotomy followed by laparoscopic cholecystectomy is an unnecessary step, as there is no evidence of common bile duct stones.
**Option D:** Laparoscopic cholecystectomy followed by ERCP + choledocholithotomy is also an unnecessary step, as the ERCP would be performed unnecessarily.
**Clinical Pearl / High-Yield Fact**
When treating chronic calculous cholecystitis, it is essential to consider the presence of common bile duct stones and liver function tests to determine the most appropriate surgical approach.
**β Correct Answer: A. Laparoscopic cholecystectomy**
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