Laparoscopic Cholecystectomy

What Is Laparoscopic Cholecystectomy?

Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by laparoscopic techniques. During a laparoscopic surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports, which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.

Why is it done?

The gallbladder is a small pear-shaped pouch situated under the liver in the upper right part of the abdomen. It stores bile, a liquid produced by the liver, and then releases it into the intestine to help digestion. The gallbladder may need to be removed to treat gallstones. Gallstones are small, hard stones, which can sometimes develop in the gallbladder. They can result in a blockage of the flow of bile out of the gallbladder and symptoms that can include pain, jaundice (yellowed skin), and fever. The body can function well without a gallbladder and removing it is a common treatment for gallstones that are causing symptoms.

What to expect after surgery?

Patients will probably be able to get back to normal activities within a week's time, including driving, walking up stairs, light lifting and work. Activity is dependent on how the patient feels. Walking is encouraged. Patients can remove the dressings and shower the day after the operation. In general, recovery should be progressive, once the patient is at home. Most patients are fully recovered and may go back to work after seven to ten days. Often, this depends on the nature of your job since patients who perform manual labor or heavy lifting may require two to four weeks of recovery.

What are the risks of the surgery?

Complications of a laparoscopic cholecystectomy are infrequent and the vast majority of laparoscopic gallbladder patients recover and quickly return to normal activities. Risks might include;

  • Bleeding
  • Infection
  • Leakage of bile in the abdomen
  • Pneumonia
  • Blood clots, or heart problems.
  • Surgical injury to an adjacent structures e.g. bile duct, duodenum or the small intestine may occur rarely and may require another surgical procedure to repair it.
  • If the gallbladder is accidentally or deliberately opened during the procedure stones may fall out of the gallbladder and in to the abdomen that may give rise to later scarring.

What are the alternatives to the surgery?

  • Oral dissolution therapy - risks of gallstones recurring/poor outcome for large gallstones
  • Cholecystostomy - removing the stones alone: usually in patients who are too sick for the whole surgery to remove the gallbladder
  • Lithotripsy - shattering the stones smaller but this may cause more symptoms/complications