A laparoscopic cholecystectomy procedure is the most common type of surgical gallbladder removal. In this type of surgery, one or more small incisions are made in the abdomen and scopes inserted with cameras, lights, and instruments attached. An open cholecystectomy, on the other hand, involves a large incision if there is scar tissue in the area or difficulty reaching the organ. Risks and complications are uncommon but may occur both from surgery and general anesthesia.
The gallbladder lies under the liver and stores bile produced by that organ until it is needed in digestion. Painful stones, or more rarely polyps, can sometimes form in the gallbladder, causing unpleasant symptoms including pain, nausea, and loss of appetite. If a stone passes from the gallbladder into either the cystic or common bile ducts, severe pain and jaundice may result. The organ may also stop functioning properly, and a cholecystectomy procedure is the only way to stop the symptoms.
A cholecystectomy procedure begins with administration of general anesthesia. The patient is told not to eat or drink anything for several hours prior to the surgery to prevent aspiration in case of vomiting. One incision is made around or above the navel, two are made on the side of the abdomen, and one is made over the stomach to admit instruments. In single-port access cholecystectomies, one cut at the navel is made for all instruments.
Carbon dioxide is pumped into the cavity to inflate it, a process called insufflation. This makes it easier to see and manipulate instruments and organs. A laparoscope with a tiny light and camera on the tip is then inserted so the surgeon can see inside the abdomen. The rest of the instruments are put through ports in the other incisions and manipulated through them.
The surgeon disconnects the gallbladder from the ducts and removes it, often through the incision over the stomach. If scarring from previous abdominal surgery is present or if the surgeon has difficulty reaching the gallbladder, the cholecystectomy procedure may be converted to an open operation. A larger incision opens the abdomen, and the arteries and ducts are tied off before the gallbladder is removed. Open cholecystectomy is major surgery with a longer recovery, but such conversions are rare.
After a cholecystectomy procedure the liver will continue to produce bile, but instead of being stored in the gallbladder it trickles into the intestine. Recovery from laparoscopic surgery is typically rapid, needing only a few days of rest, pain medication, and minimal restrictions on heavy lifting. A normal diet may be resumed as soon as the patient feels better. Complications are rare but can include infection, bleeding, bile leakage, and blood clots. Uncomfortable and painful symptoms are generally relieved by the surgery.
