Laparoscopic Gallbladder Surgery – Cholecystectomy

About gallbladder surgery

Gallbladder removal is considered the most effective method for addressing symptoms caused by gallstones, including post-meal pain known as gallbladder colic. Laparoscopic gallbladder surgery, a minimally invasive approach that reduces recovery time and risk of complications, is the first choice in abdominal surgery for gallbladder removal to prevent recurrence of symptoms.

What is laparoscopic gallbladder surgery?

Gallbladder surgery, or cholecystectomy, is a surgical procedure to remove the gallbladder (also known as the cholecyst). The gallbladder is a small, pear-shaped organ that acts as a reservoir for bile, a digestive fluid produced by the liver. Bile, composed of bile salts, helps digest and absorb fats and some vitamins, and also removes certain waste products from the body (hemoglobin and excess cholesterol). Bile from the liver reaches the gallbladder through the bile duct, and the rest is directly released into the small intestine. In the gallbladder, bile becomes more concentrated, and it is expelled into the small intestine during meals to mix with food and aid digestion. After surgical removal of the gallbladder, bile is released directly into the small intestine, so although this process is useful, it is not essential for the normal functioning of the bile system.

Gallbladder surgery can be performed in two ways:

• Open surgery: Through a larger (about 10 cm) incision in the abdomen.
• Laparoscopy: A minimally invasive method through 3 or 4 smaller incisions (about 1 cm each).

Laparoscopic gallbladder surgery allows for quicker and easier recovery, with reduced bleeding and risk of complications.

When is gallbladder surgery necessary?

Gallbladder surgery is usually indicated for patients who have symptoms caused by gallstones. These are small, hard deposits, similar to stones, formed from bile byproducts—primarily cholesterol and bilirubin—that can develop in the gallbladder or bile duct. The presence of gallstones does not always lead to symptoms, but when they obstruct the flow of bile from the gallbladder to the digestive system, they can cause severe pain (gallbladder colic) along with possible inflammation of the gallbladder (cholecystitis) or pancreas (pancreatitis). If they enter the bile duct, jaundice—yellowing of the skin and eyes—may occur. Less commonly, tumors and polyps can also obstruct the normal flow of bile.

Gallbladder colic is a characteristic type of pain associated with gallstones, spreading from the upper right or central abdomen to the right shoulder blade, arm, armpit, or chest. The pain may be sharp, dull, or cramp-like, and can be continuous or intermittent. It typically occurs in the evening, after heavy, fatty meals, and lasts from 30 minutes to several hours.

In addition to pain and jaundice, symptoms of gallstones include:

• Nausea
• Vomiting
• Bloating
• Fever
• Chills

Gallbladder surgery is not necessarily required for patients without symptoms, despite the presence of gallstones. However, to avoid more severe complications, it is recommended in cases of:

• Chronic, frequent episodes of gallbladder colic and jaundice
• Recurrent inflammation or infection of the gallbladder, bile duct, or pancreas
• Presence of large polyps in the gallbladder

How is laparoscopic gallbladder surgery performed?

The procedure is carried out under general anesthesia, meaning you are unconscious and insensitive to pain, and lasts 1 to 2 hours. After anesthesia is administered, the surgeon makes 4 small incisions in the abdomen through which various instruments (trocar and laparoscope) are inserted to remove the gallbladder. A special needle is used to introduce carbon dioxide gas through an incision near the navel to separate the organs and improve visibility within the abdominal cavity.

A laparoscope, a thin optical tube with a light and camera, is then inserted, allowing real-time visualization of the organs on a monitor. Additional instruments are introduced through the other incisions to remove the gallbladder. The procedure concludes with closing the incisions with stitches and applying small bandages.

In rare cases, due to complications or scar tissue from previous abdominal surgeries, laparoscopy may be converted to an open surgery through a larger abdominal incision.

Risks of gallbladder surgery

Although laparoscopy as a minimally invasive method reduces the risk of complications, there are still potential risks associated with anesthesia, increased bleeding, or infection.

Other less common risks of gallbladder surgery include:

• Leakage of bile due to injury to the bile duct
• Damage to surrounding organs
• Changes in sensation at the incision sites
• Hernia at the incision site
• Formation of internal adhesions
• Poor healing or hypertrophy of scars
• Formation of blood clots

Preparation for gallbladder surgery

Before the procedure, it is necessary to confirm the diagnosis of gallstones through an abdominal ultrasound and rule out other possible pathologies. During the pre-surgery consultation with the surgeon, you will receive specific recommendations and the best treatment method based on your symptoms and overall medical history. If laparoscopic cholecystectomy is indicated, you will need to:

• Undergo blood tests, EKG, spirometry, and a consultation with an anesthesiologist (chest X-ray depending on age)
• Showering with antibacterial soap the day before and on the day of the procedure
• Fasting for 8 hours before the procedure
• Removing jewelry and nail polish
• Perform preoperative bowel cleansing as instructed by medical staff

It is also recommended to stop taking blood-thinning medications (Andol, Aspirin) and non-steroidal anti-inflammatory drugs (Brufen, Voltaren, Ketonal, etc.) 2 weeks before the procedure. During this time, it is advisable to abstain from alcohol consumption. Avoid alcohol during this period as well.

Recovery from gallbladder surgery

After laparoscopic gallbladder surgery, recovery is relatively quick with minimal pain and visible scarring. You will stay overnight at the clinic for observation.

Return to normal activities is expected after one week, and light movement is recommended to prevent blood clots.

It is important to avoid heavy physical exertion and lifting heavy objects for 6 to 8 weeks.

Post-operative diet

After gallbladder removal, less concentrated bile directly enters the digestive system, which can make digestion more challenging and cause bloating and diarrhea.

Therefore, for at least a month after the procedure, a bile-friendly diet is recommended, which includes:

• Smaller, more frequent meals
• Avoidance of fatty and fried foods (especially during the first week)
• A fiber-rich diet for regular bowel movements

Cost of gallbladder surgery

Check the current price list for the procedure cost.

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