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Laparoscopic Cholecystectomy vs. Open Cholecystectomy  

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Definition  

Cholecystectomy is the surgical removal of the gallbladder. This procedure is most often done laparoscopically. This is done through several small incisions in the abdomen. In some cases, the doctor may switch to open surgery. This involves a larger incision in the abdomen.

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Reasons for Procedure  

This surgery is used to remove a diseased or damaged gallbladder. The damage is typically caused by infection or inflammation. This is often due to gallstones, which are crystals of bile that can form in the gallbladder. Sometimes, these get stuck in the ducts that bile normally flows through. This blockage in the ducts can damage the gallbladder and the liver.

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Possible Complications  

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Gallstones that have accidentally entered the abdominal cavity
  • Bleeding
  • Infection
  • Injury to other nearby structures or organs
  • Reactions to general anesthesia
  • Blood clots

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

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What to Expect  

Prior to Procedure  

Your doctor will probably do some or all of the following:

  • Blood tests to evaluate liver function
  • Ultrasound to view gallstones
  • Hepatobiliary iminodiacetic acid (HIDA) scan—an x-ray test that uses a chemical injected into the gall bladder to create pictures of your liver, gallbladder, ducts, and small intestines
  • EKG and chest x-ray —to make sure that the heart and lungs are healthy enough for surgery
  • MRI or CT scan to better view the gallbladder

Leading up to your procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
  • Arrange for a ride to and from the procedure. Also, have someone help you at home.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • You may be given:
    • Laxatives and/or an enema
    • Antibiotics
  • If instructed, shower before the procedure. You may be given special soap to use.

Anesthesia  

General anesthesia will be used. You will be asleep for the procedure.

Description of Procedure  

Four small openings will be made in your abdomen. Carbon dioxide will be pumped into the abdomen to provide a better view.

The laparoscope will be inserted through one of the openings. It will provide images of the gallbladder and surrounding area. Instruments will be inserted through the other openings. They will be used to grasp the gallbladder and clip off the main artery and duct. The gallbladder will be removed through one of the openings. Dye may be injected into the duct to look for stones, which may be removed if found. The entire abdomen will be carefully examined. The incisions will be closed with sutures or staples. They will be covered with bandages.

A tiny, flexible tube may be placed into the area. This tube will exit from your abdomen into a little bulb. This is to drain fluid. The tube is usually removed within one week.

Immediately After Procedure  

You will be taken to a recovery room.

How Long Will It Take?  

About 30-60 minutes

How Much Will It Hurt?  

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay  

If you do not have any problems, you may be able to go home the same day as the surgery or the next day.

Post-procedure Care