Illustration

What is a laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is a surgical procedure in which the doctor removes your gallbladder with the aid of a laparoscope (small camera that can be inserted into the abdomen) and other surgical tools through four small incisions. Laparoscopic cholecystectomy is the most common way to remove the gallbladder today, but you should always keep in mind that cholecystectomy cannot always be done laparoscopically and sometimes a larger incision is needed (see "Cholecystectomy")

When is it done?

This procedure is performed when you have stones or inflammation in your gallbladder, causing pain. The gallbladder is shaped like a small balloon. It is attached to the liver and holds bile. Bile is produced in the liver and helps with digestion of fatty foods. Small particles of bile can form a sediment in the gallbladder that can turn into gallstones. These stones may remain loose in your gallbladder or they may block the gallbladder outlet causing pain when the gallbladder contracts. In that case the gallbladder may also become swollen, inflamed, and/or rarely start to decompose (become "gangrenous").

There are no alternatives to surgically removing the gallbladder when it is causing pain.

How do I prepare for a laparoscopic cholecystectomy?

Follow the instructions provided by the doctor. The night before the procedure eat a light meal. Do not eat or drink anything after midnight and on the morning before the procedure. Do not even drink coffee or tea. You may be able to take some or all of your normal medicines with a sip of water. Ask your surgeon about this before the operation.

What happens during the procedure?

A general anesthetic is given to put you to sleep in the operating room. A general anesthetic will relax your muscles and keep you from feeling pain during the operation.

For the surgeon to see inside you with the camera, your abdomen must be inflated with carbon dioxide gas. This lifts the abdominal wall and helps the doctor see your gallbladder. The doctor makes three or four small incisions in your abdomen, puts in special instruments to remove your gallbladder.

What happens after the procedure?

Most laparoscopic gallbladder removals are done as outpatient operations, without admission to the hospital. If you are admitted to the hospital after the operation, you may be able to leave the hospital the next morning, depending on your condition. Most patients have some incisional discomfort, nausea and sometimes shoulder pain for 1-3 days after surgery, but most return to full, normal activities within 5 to 10 days. There are usually no restrictions on lifting or exercising.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

Removing the gallbladder stops the attacks of abdominal pain that were caused by gallstones. You return to normal activity rapidly. The scars are very small.

What are the risks associated with this procedure?

• Laparoscopic operation may not be possible because of anatomic variations, adhesions and/or inflammation.
• There are risks when you have general anesthesia. Discuss these risks with your anesthesiologist.
• You may have pain in your right shoulder. The pain is probably the result of the operation and goes away in 2-3 days.
• There is a risk of bleeding and wound infection, as with any operation.
• The common bile duct or a loop of bowel may be damaged. If this happens, you may need further, more complex surgery to repair it.
• Bile may leak from where the gallbladder has been removed and collect in your abdomen causing jaundice. To correct this, the doctor may have to put in a drainage tube.

You should ask your doctor how these risks apply to you.

When should I call the doctor after surgery?

Call the doctor immediately if:

• You develop a fever.
• You are in a lot of pain.
• You develop nausea or vomiting or cannot eat properly.
• Your eyes or skin become yellow, a sign of jaundice.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.
  

Edited by Richard E. Burney, MD, UMHS General Surgery, October, 2005

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.