Laparoscopic Cholecystectomy
The operation
Laparoscopic cholecystectomy or keyhole removal of gallbladder is the operation of choice. This involves 4 small incisions on the skin as shown and an operation that usually takes between 45 and 60 minutes. It is done under general anaesthetic and the abdomen is inflated allowing the surgeon to use long instruments to remove the gallbladder.
On table cholangiogram
During the procedure a special X-ray is performed called a cholangiogram. This confirms the presence or absence of gallstones in the common bile duct. A small number of patients (4%) will have common bile duct stones and these can often be retrieved during the keyhole operation. Occasionally this is not possible and then an endoscopic procedure (camera test down through the stomach) will be carried out after a few days to remove the stones. Secondly the cholangiogram confirms the anatomy of the bile duct and gives the surgeon a road map of the biliary tree. Bile duct injury is very rare but a serious complication of this operation.
Following Surgery
The stitches used will dissolve under the skin. After a few hours recovery on the ward most people are discharged the same day. The average time back to normal activity following a laparoscopic cholecystectomy is 10 days with a range from 2 to 21 days.
Life without a gallbladder
Following this operation the body adapts to not having a gallbladder. The liver still produces 500mls of bile a day but it is now stored in the common bile duct which doubles in width. The normal diameter before surgery is 0.5mm. Most people notice no change in their overall make up other than the fact that they feel better and their pain has gone away.
Very occasionally it is not possible to remove the gallbladder safely with keyhole surgery and so an open operation is performed. This means the patient will stay in hospital 3 days and is likely to be back at work after a month.