Cholecystectomy – Gallbladder Removal Surgery
A cholecystectomy is the surgical removal of the gallbladder. It is commonly performed to treat gallstones or gallbladder inflammation and is considered a safe and routine procedure.
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A cholecystectomy is the surgical removal of the gallbladder. It is commonly performed to treat gallstones or gallbladder inflammation and is considered a safe and routine procedure.
What is a Cholecystectomy?
A cholecystectomy is a surgical procedure in which the gallbladder is removed. The gallbladder is a small, pear-shaped organ located beneath the liver. Its primary function is to store bile produced by the liver and release it into the small intestine to aid in the digestion of fats. When the gallbladder becomes diseased -- most commonly due to gallstones or inflammation -- surgical removal may be recommended. Cholecystectomy is one of the most frequently performed abdominal surgeries worldwide.
Indications
A cholecystectomy is typically recommended in the following situations:
- Gallstones (cholelithiasis): Hardened deposits in the gallbladder that cause pain or lead to complications.
- Gallbladder inflammation (cholecystitis): Acute or chronic inflammation of the gallbladder, often caused by gallstones.
- Common bile duct stones (choledocholithiasis): Stones blocking the bile duct, potentially causing jaundice or pancreatitis.
- Gallbladder polyps: Growths that carry a risk of becoming malignant.
- Gallbladder cancer (gallbladder carcinoma): In early stages, removal can be curative.
Procedure
Laparoscopic Cholecystectomy
The preferred technique is laparoscopic cholecystectomy, also known as keyhole surgery. Several small incisions are made in the abdomen, through which a camera (laparoscope) and surgical instruments are inserted. The procedure is performed under general anesthesia and typically lasts between 45 and 90 minutes. Benefits include shorter hospital stays, less postoperative pain, and faster recovery compared to open surgery.
Open Cholecystectomy
An open cholecystectomy involves a larger incision in the upper abdomen. This approach is used when laparoscopic surgery is not feasible -- for example, in cases of severe inflammation, adhesions, or intraoperative complications. Recovery time and hospital stay are longer with this method.
Preparation and Aftercare
Before surgery, blood tests, an abdominal ultrasound, and potentially additional imaging studies are performed. Patients are typically required to fast from the evening before the procedure. After the operation, a low-fat diet is recommended until the digestive system adjusts to the absence of the gallbladder. Most patients who undergo laparoscopic surgery are able to resume normal activities within a few days.
Risks and Complications
Cholecystectomy is generally safe, but potential complications include:
- Injury to the bile duct
- Bleeding
- Wound or abdominal infections
- Bile leakage after surgery
- Injury to adjacent organs such as the bowel or liver
- Anesthesia-related complications
A small number of patients may develop post-cholecystectomy syndrome, characterized by persistent upper abdominal discomfort, bloating, or diarrhea following surgery.
Life Without a Gallbladder
After removal of the gallbladder, bile flows continuously from the liver directly into the small intestine rather than being stored. Most people adapt well and lead a normal, symptom-free life. In the initial weeks after surgery, a low-fat diet can help minimize digestive discomfort during the adjustment period.
References
- Lammert F. et al. - S3 Guideline for Diagnosis and Treatment of Gallstones. AWMF Clinical Guideline (2018).
- Strasberg S.M. - Acute Calculous Cholecystitis. New England Journal of Medicine, 2008; 358(26): 2804-2811.
- World Health Organization (WHO) - Essential Surgery: Disease Control Priorities (3rd edition), Volume 1, 2015.
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