Treatment Options

Laparoscopic Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder. Using advanced laparoscopic technology, it is now possible to remove the gallbladder through four tiny incisions in front of the abdomen.

Indications for Laparoscopic Gall Bladder removal (Cholecystectomy)

• Once a patient develops symptoms the risk of further attacks of pain and complications is high and surgery is recommended
• As diabetics with gallstones have a higher risk of complications and infection they should usually have their gallbladder removed
• Pancreatitis is commonly caused by gallstones. When no obvious cause is found cholecystectomy is often recommended as a significant proportion of these patients have microscopic stones that may cause further attacks.
• Gallbladder polyps or tumours
• Gallstones are very common. If gallstones are found incidentally in patients without any symptoms they can usually be observed as the risk of developing problems is only about 2-3%.

What are the Benefits?

Open surgery to remove the gallbladder requires a large incision, 5-7 days in hospital and many weeks to fully recover. The main benefit of laparoscopic cholecystectomy is that it is minimally invasive surgery. Minimally invasive surgery means "Lesser Pain" and "Faster Recovery". The majority of patients are discharged the day after surgery. Most patients resume normal activities within 1-2 weeks following their procedure.

Is laparoscopy always advised?

There are very few instances when laparoscopic surgery is not preferable to conventional open surgery for cholecystectomy.  

• Obesity - there are fewer post-operative complications with laparoscopic surgery.
• Previous surgery - adhesions can often be dealt with successfully.
• Common bile duct stones can be removed by laparoscopy, or by ERCP.
• Severe cholecystitis is best dealt with acutely - one operation and recovery period - and can be done safely with laparoscopic technique.
• Pregnancy – the gallbladder can easily be removed during the first half but in the later stages of there may not be enough space to operate.

Risks & Complications

Laparoscopic Cholecystectomy is one of the most commonly performed operations.

Complications are rare and may include:

• Bleeding & infection may occur with any surgery
• Conversion to an open procedure may be required if the gallbladder cannot be safely removed by keyhole surgery. This is uncommon in the hands of a skilled surgeon but the risk increases with a severe attack of cholecystitis or if surgery is delayed
• Retained stone – if a stone has passed from the gallbladder into the bile duct this would be left behind if only the gallbladder is removed. An x-ray is performed routinely during your surgery with a special “dye” injected into the bile ducts to look for stones. Sometimes a skilled laparoscopic surgeon like Mr Krishna Epari can remove these using keyhole surgery. If that is unsuccessful then an ERCP will be required as a subsequent procedure.
• Bile leak – leakage of bile from the duct or the liver where the gallbladder has been removed occurs in about 1 in 200 cases. A further procedure for drainage or an ERCP may be required to stop the leak.
• Bile duct injury – damage to the bile duct tubes that join the gallbladder to the liver and bowel occurs in about 1 in 300 cases. It is usually only a risk when severe inflammation causes the gallbladder to stick to the bile ducts making them difficult to separate. Management requires a specialist Hepato-Biliary surgeon like Mr Krishna Epari to perform a complex reconstruction.