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Laparoscopic Cholecystectomy

What is this?

This is a keyhole operation to remove the gallbladder. It is a very common operation.

When is it performed?

The operation is performed for symptomatic gallbladder disease. Most commonly it is due to gallstones

Operation details

The operation is performed under general anaesthesia and takes about 1 hour. The duct from the gallbladder to the main bile duct is identified and ligated. The gallbladder is removed with the contained stones. During the operation an x-ray is often performed to look at the bile ducts. Most patients are in hospital for 24hrs.

Why can’t the stones be removed leaving the gallbladder behind?

While the stones cause the symptoms the disease is in the gallbladder and even if the stones could be removed (not technically possible), they would simply reform.

Can the stones be shattered like kidney stones?

No. The problem is the gallbladder. Also making the stones smaller will cause other problems when the fragments enter the bile ducts (cholangitis and pancreatitis)

Can the stones be dissolved?

There are medications that dissolve stones but they cause many complications and are unavailable in Australia. Surgery is safer.

Can you live normally without a gallbladder?

In humans the gallbladder is not as important as in some animals and patients can lead a completely normal life without one. Almost all patients will resume a normal diet. Some patients can get diarrhoea as a result of the slightly increased amount of bile entering the gut. This is usually mild and easily treated.

What are the complications?

All operations have complications. The specific complications for cholecystectomy are very rare.

  • Conversion to open surgery: sometimes the operation cannot be completed laparoscopically and open surgery is required. This is rare (1 in 500). Reasons include difficult visualisation due to severe inflammation, bleeding and damage to structures.
  • Damage to the bile ducts: this is a very serious complication and requires major surgery to reconstruct the anatomy. The ducts can be poorly visualised due to abnormal anatomy or severe inflammation.
  • Bleeding: There are major blood vessels near the gallbladder. Sometimes there can be bleeding from the gallbladder bed where the gallbladder has been removed.
  • Infection: There can be infections in the abdomen or wound. Antibiotics are routinely given. 
  • Bile salt diarrhoea: a rare complication that sometimes needs medications. It presents with loose stool after fatty meals. Treatment is simple with medications.

When can I resume a normal diet?

A normal diet is recommenced immediately. There are no restrictions but a few patients may have some loose stool with fatty foods. This lasts for a few days in most patients but can be easily treated if persistent.

When can I resume normal activities and work?

Most patients require about a week before resuming all normal activities.

What is the follow up?

You will see Dr Pathma-Nathan after a few weeks.

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