Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy

What is a laparoscopic cholecystectomy?

A laparoscopic cholecystectomy is the surgical removal of your gallbladder through several small incisions and a laparoscope. A laparoscope is a long, thin camera that allows your doctor to see the surgical area on the video screen during gallbladder removal. Your doctor may recommend a laparoscopic gallbladder surgery if you develop gallstones (cholelithiasis) that cause pain.

The gallbladder is located in the upper right side of your abdomen under the liver. The pear-shaped gallbladder is a hollow sac that concentrates and stores bile produced by the liver. Bile moves from the gallbladder through the bile duct into the small intestine during digestion. A gallstone can move from the gallbladder and block a bile duct, causing irritation, pain and swelling of the gallbladder (cholecystitis) .

A laparoscopic cholecystectomy—as called lap cholecystectomy—is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a laparoscopic cholecystectomy.

Other procedures that may be performed

  • Endoscopic retrograde cholangiopancreatography (ERCP) locates and removes a gallstone that is stuck in the bile duct. It involves using an endoscope to access the bile duct. An endoscope is a long, lighted camera that transmits pictures of the inside of your body to a video screen during surgery. Your doctor will pass the endoscope down your throat and through the stomach into the small intestine. Your doctor will remove the stone through the endoscope.
  • Laparoscopic common bile duct stone extraction is another procedure used to locate and remove a gallstone that is stuck in the bile duct. It involves inserting surgical instruments through small abdominal incisions and remove the stone through the bile duct with a small basket or crush the stone.
  • Open surgery involves making a larger incision that allows your doctor to directly see and remove the gallbladder. It is possible that your doctor may decide after beginning a laparoscopic cholecystectomy that you require open surgery to complete your surgery.

Why is a laparoscopic cholecystectomy performed?

  • Cholecystitis, which is inflammation of the gallbladder resulting in severe pain called biliary colic. A gallstone that gets stuck in a bile duct that carries bile to or from the gallbladder causes cholecystitis.
  • Choledocholithiasis, which is a gallstone that moves into the bile duct. In some cases, the gallstone will pass by itself. If it gets stuck in the bile duct it can cause inflammation of the gallbladder and possibly the pancreas.
  • Cholelithiasis (gallstones) in the gallbladder, if they cause frequent or severe pain
  • Gallbladder mass, which can be due to gallbladder cancer or from a benign (noncancerous) tumor
  • Gallstone pancreatitis, which is inflammation of the pancreas caused by a gallstone that gets stuck or passes through the bile duct. A gallstone in the bile duct can also block the pancreatic duct. The pancreatic duct carries digestive juices from the pancreas.
  • Perforated gallbladder, which is leaking or bursting of the gallbladder
  • Biliary dyskinesia occurs when the gallbladder does not empty bile correctly. This can cause symptoms similar to cholecystitis.

  • How is a laparoscopic cholecystectomy performed?
  • How do I prepare for my laparoscopic cholecystectomy?
How is a laparoscopic cholecystectomy performed?

Your laparoscopic cholecystectomy will be performed in a hospital. Your surgeon will make four small incisions in your upper abdomen and insert tiny instruments and a laparoscope through the incisions. A laparoscope is a long, thin camera that transmits pictures of the inside of your body to a video screen. Your surgeon sees the surgical area on the video screen while performing the surgery.

Dye may be injected via a catheter into the bile duct to confirm the anatomy and to ensure that no stones are in the common bile duct. After the dye injection and X-ray, the gallbladder duct is clipped and the gallbladder removed from one of the small openings.

Surgeons sometimes combine laparoscopic cholecystectomy with open surgery. Open surgery involves making a larger incision to directly view and treat the surgical area.

How do I prepare for my laparoscopic cholecystectomy?
  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Getting preoperative testing as directed. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed. Other tests may include testing for signs of infection, biliary obstruction, pancreatitis, or jaundice (yellowing of the skin and eyes).
  • Losing excess weight before the surgery through a healthy diet and exercise plan
  • Not eating or drinking before surgery as directed. Your surgery may be canceled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

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