(with on-table cholangiogram)
Once symptomatic gallstones are diagnosed, Laparoscopic Cholecystectomy is the recommended approach to remove the gallbladder.
Surgery is performed under a general anaesthetic using four small incisions on the abdominal wall. A miniature camera and specially designed instruments are used. The abdominal organs are inspected, and the gallbladder identified. A special X-ray of the bile ducts is sometimes performed (cholangiogram) to ensure the anatomy is clearly identified and that there are no stones in the bile duct which may require further treatment. All surgery is performed inside the abdomen with the entire gallbladder containing the stones removed. The skin is closed using dissolving stitches. In some people there may be some minor bruises in the first week, which usually settles down.
The advantages of laparoscopic approach include:
- Less postoperative pain
- Reduced hospital stay
- Quicker physical recovery
- Less wound scarring
Laparoscopic cholecystectomy is the treatment of choice for all patients presenting with any of the complications of gallstones described above from biliary colic to acute cholecystitis and pancreatitis.
What are the main risks of surgery?
Your surgeon will advise on any specific complications and risks. For all types of surgery there is always a risk of wound infection. Specifically, for laparoscopic cholecystectomy there is always a small risk of undergoing an open operation instead of keyhole in 3-5% of patients and a risk of bile duct injury of <0.3% (National quoted figure). Your surgeon will discuss this with you prior to surgery.
What happens after surgery?
You will be able to eat and drink after your operation. The operation is usually straightforward and most people are usually well enough to go home within twenty-four hours. Most people should be well enough to engage in gentle sporting activities in 7 to 10 days.
There is no special dietary restriction following gallbladder removal and you can live without your gallbladder. In a small minority of individuals (2%), there may be increased bowel frequency following gallbladder removal because bile flows directly into the intestine from the liver but this usually settles down most of the time.
Driving can be resumed after 7 days but do check with your insurance company first for appropriate cover.
Most patients fully recover from surgery within two weeks.
Incisions used for laparoscopic cholecystectomy
Diagram of abdomen shown below
Traditionally four incisions are used for this procedure
Gallbladder Surgery Diagram