Laparoscopic Cholecystectomy
What is a laparoscopic cholecystectomy?
Laparoscopy is an operation where the surgeon looks inside your abdomen (tummy) using a fibre-optic camera called a laparoscope. Operations using this method are often called ‘keyhole’. Cholecystectomy is the medical term for surgery to remove the gall bladder.
What does the gall bladder do?
The gall bladder stores and concentrates bile that has been produced in the liver. After a meal the gall bladder squeezes and empties bile into the first part of the bowel where it then helps fat digestion. In some people gritty bits are left in the gall bladder and this causes one or more gallstones to form.
Why might I need my gall bladder removed?
Usually this is because it is giving you pain due to gall stones. These stones form in the gall bladder and can cause a range of problems including pain, jaundice (yellowing of the skin and whites of eyes), infection and pancreatitis. Gall stones are very common but do not always cause symptoms and can be left alone if they are not causing any discomfort.
Some patients with gall bladder polyps may also require a cholecystectomy.
How is the operation carried out?
This operation is now routinely done as keyhole surgery. For most operations you do not need to have the hair around the site of the operation removed, however, sometimes this may be necessary and they will use an electric hair clipper with a single-use disposable head on the day of the surgery.
Please do not shave the hair yourself or use a razor to remove hair, as this can increase the risk of infection. Your healthcare team will be happy to discuss this with you.
A small cut is made near your belly button and carbon dioxide gas is pumped into the abdomen. This creates more room for your surgeon to work and makes it easier to see the internal organs. Four small cuts (measuring between 0.5-1cm) are made in the tummy wall so that a fibre-optic camera and the instruments can be passed through and used to remove the gall bladder.
During the operation, if the surgeon feels it is necessary, a special x-ray will be performed known as an On Table Cholangiogram. This is to check to see if there are stones in the bile duct. If stones are located in the duct the surgeon will attempt to clear them, however this isn’t always possible and a procedure called an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) will be organised once you have recovered from your present surgery.
On occasions the gall bladder may become stuck to the liver due to previous inflammation. In this case a small drainage tube may be placed in the area from which the gall bladder was removed to monitor for possible bile leakage. This tube will be removed 12 to 24 hours after the operation.
It is rare that the operation cannot be completed using the keyhole technique. In these cases the procedure will be changed to an open operation and a cut will be made across the tummy wall. At the end of the operation the cuts are closed with stitches which will dissolve and do not need to be removed; clear adhesive dressings will be applied.
What will happen after your operation?
Some discomfort is usually experienced from the small cuts and local anaesthetic is injected into these incisions to reduce this. Shoulder tip pain may be experienced for 24 to 48 hours, and this is thought to be due to the gas used during the operation.
You will be prescribed simple pain killers such as paracetamol and ibuprofen and most patients will usually be able to go home the same day.
