The gallbladder is a pear-shaped organ that sits beneath the liver in the right upper abdomen. It stores and releases bile (a digestive fluid) produced by the liver to help absorb consumed fat.
Cholecystectomy is the term used for the removal of the gallbladder via surgical interventions. (1) Laparoscopy is a “minimally invasive” technique where the surgeon accesses the inside of your abdomen and/or pelvis by making several small incisions in the skin rather than a large one. The gallbladder is typically removed laparoscopically using 3-4 small incisions.
This scientific intervention has rapidly become the procedure of choice for routine cholecystectomy and is currently the most commonly performed major abdominal procedure in Western countries. According to a report published in 2018, of all the cholecystectomy procedures, 90% were done laparoscopically. (2)
This article will discuss in detail why it is needed, its process, and associated risks. Let’s start!
When is a Laparoscopic Cholecystectomy Needed?
Occasionally, stones can form in the gall bladder which can cause pain, inflammation, and sometimes, serious infections. When this happens, the gallbladder’s removal becomes inevitable. Laparoscopic cholecystectomy offers quick removal of the gallbladder to address and prevent these issues.
Gallstones and their related complications are the major reason why cholecystectomy is recommended. The gallstones may block the flow of bile from the gall bladder into your GI tract. This obstruction causes inflammation of the gall bladder and sometimes, infection. Doctors may recommend a cholecystectomy for: (2)
- Gallstones in the gallbladder (cholelithiasis)
- Gallstones in the bile duct (choledocholithiasis)
- Gallbladder inflammation (cholecystitis)
- Pancreas inflammation (pancreatitis) due to gallstones
Symptoms of these gallstones may include (2)
- Bloating and other digestive issues
- A sharp pain in the abdomen, particularly on the right side that spreads to the shoulder and back
- Nausea and vomiting
- Yellowing of the skin (Jaundice)
What is the Process for a Laparoscopic Cholecystectomy?
Laparoscopic cholecystectomy starts with anesthesia. When you fall asleep, the surgeon will make several small incisions along your abdomen. This is followed by the insertion of a small hollow tube approximately 5 to 10 mm in diameter into the abdomen, called a port, where CO2 can be temporarily introduced, and air fills the abdominal cavity creating a space to work. This also increases the visibility for the surgeon to aid in safe removal of the gallbladder.
Several other ports are inserted by the surgeon such as a laparoscope (a video camera, with a light source at the end) and other laparoscopic instruments to aid in the removal of the gallbladder. The camera shows the surgery on the screen in the room.
Once all is clear and visible, the surgeon will identify and dissect out the cystic duct and the cystic artery, closed with clips, and then cut them. The gallbladder’s attachments to the liver are then separated and divided using cautery until it is free. The gallbladder is then taken out through one of the inserted ports. (3)
The incisions are then closed with dissolvable sutures. Surgical glue, or tape may be placed on top of the incisions. The surgery usually takes an hour or two.
How Much Does a Laparoscopic Cholecystectomy Cost?
The price of a laparoscopic cholecystectomy varies by location and by clinic. Below is a price list that outlines average price by country. (5)
|Laparoscopic Cholecystectomy Price Table|
|United States of America||$5,060|
Cost data estimated from information gathered by Wesley Jacobs of Apollo Medical Travel based on publicly available price information in the United States and of providers offering cholecystectomy procedures in Apollo’s network of clinics.
What Are the Benefits of a Laparoscopic Cholecystectomy?
Cholecystectomy allows removal of the source of pain and inflammation from gall stones. It can also prevent infection if one of the stones were to become dislodged.
One may wonder whether open or laparoscopic surgery is best. Below is the list of a few benefits of laparoscopic procedures over open surgery. (4)
- Less painful, reducing the need for pain medications.
- Small incisions each less than 10 mm, contrary to 5-7 inch incision for open surgery.
- Shorter hospital stay
- Faster recovery time
- Smaller wounds and scars
What are the Risks of a Laparoscopic Cholecystectomy?
Although the procedure is simple and safe, like any other surgery, it cannot be declared free of risks or complications. Although rare, the risks associated with laparoscopic gallbladder removal may include:
- Complications from anesthesia such as blood clotting or pneumonia
- Systemic carbon dioxide absorption
- Bleeding or blood clotting
- Bile leak
- Bile duct, liver, or intestinal injuries
- Inflammation and infection in the abdomen
- Scars from the incisions
- Numbness in the surgical area
Post-Op Cholecystectomy Care
After cholecystectomy, your doctor may recommend you do the following for a fast and healthy recovery:
- Eat high fiber food to help your bowel movements
- Increase your intake of water
- Avoid lifting heavy weights
- Slowly increase your physical activities
- Walk every day to prevent the formation of blood clots
For the majority, gallstones are a benign condition and most don’t even know that they have them. However, gallstones are not something to be ignored if you are symptomatic. They can be very painful and sometimes dangerous, leading to infection. If you have pain in your upper right abdomen, jaundice, nausea, or vomiting, immediately approach your healthcare provider.
A laparoscopic cholecystectomy is a safe and effective way to remove the gallbladder and prevent gallstones from coming back. Most people get back to their normal healthy life within a week or so. See your healthcare provider if it takes you longer to recover or if you have concerns for possible complication.
- Abraham S, Rivero HG, Erlikh IV, Griffith LF, Kondamudi VK. Surgical and nonsurgical management of gallstones. Am Fam Physician. 2014;89(10):795-802.
Read on PubMed
- Ingraham AM, Cohen ME, Ko CY, Hall BL. A current profile and assessment of north american cholecystectomy: results from the american college of surgeons national surgical quality improvement program. J Am Coll Surg. 2010;211(2):176-186. doi:10.1016/j.jamcollsurg.2010.04.003
Read on PubMed
- Yeo CJ. Shackelford’s Surgery of the Alimentary Tract. Philadelphia, PA: Elsevier; 2019.
Read on Science Direct
- Yamashita Y, Takada T, Kawarada Y, et al. Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):91-97. doi:10.1007/s00534-006-1161-x
Read on PubMed
- 2021 Coding & Payment Quick Reference Select Laparoscopic Cholecystectomy Procedures with and without Common Bile Duct Exploration (CBDE). bostonscientific.com. https://www.bostonscientific.com/content/dam/bostonscientific/Reimbursement/Gastroenterology/pdf/cholecystectomy-coding-and-payment-quick-reference-guide.pdf. Published January 1, 2021. Accessed December 2, 2021.
This article is intended for informational purposes only. It is not meant to be used as medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you have surrounding a medical condition. Never disregard professional medical advice or delay in seeking it as a result of anything you read on this Site.
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