Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy, commonly known as “keyhole gallbladder surgery”, is an operation in which the gallbladder is removed through a few small incisions in the abdominal wall, with the help of a camera. The gallbladder is a small organ located beneath the liver that stores the bile produced in the liver.

Gallstones (cholelithiasis) and the symptoms they cause are the most common reason for this operation. Today, the keyhole method is the established and widely preferred approach in gallbladder surgery; compared with open surgery, it is generally associated with smaller incisions, less pain and a shorter hospital stay.

This operation is generally considered in the following situations:

• Gallstones causing pain or indigestion symptoms
• Inflammation of the gallbladder (acute or chronic cholecystitis)
• A previous episode of inflammation of the pancreas caused by gallstones (biliary pancreatitis)
• Gallbladder polyps with certain features
• Some situations in which the gallbladder has lost its function (biliary dyskinesia)

For stones found by chance that have never caused symptoms, the decision to operate is assessed separately for each patient. Your doctor decides whether the operation is suitable for you, together with your examination and test results.

The operation is performed under general anaesthesia (you are fully asleep). Usually three or four small incisions, about 0.5-1 cm long, are made in the abdomen. The abdomen is inflated with carbon dioxide gas to provide a clear view.

A camera (laparoscope) is inserted into the abdomen through one of the incisions, and fine surgical instruments through the others. After the gallbladder’s artery and the bile duct have been safely sealed, the gallbladder is separated from its bed on the liver and taken out through one of the small incisions. In most patients the operation takes about an hour; this time may vary from person to person.

Rarely, if safety cannot be ensured during the operation, it may be necessary to switch from keyhole surgery to open surgery. This is not a failure but a decision that puts patient safety first.

Laparoscopic cholecystectomy is generally considered a safe operation; however, like any surgical procedure, it carries some risks:

• Bleeding and infection at the incision sites
• Injury to the bile ducts or bile leakage (rare)
• Injury to surrounding organs (such as the bowel or liver) (rare)
• Risks related to anaesthesia
• Blood clot formation in the leg veins (deep vein thrombosis)
• The possibility of switching to open surgery

If you notice severe and persistent abdominal pain, fever, yellowing of the skin and eyes, or redness or discharge at the incision sites after the operation, it is important to contact your doctor without delay. Because the risks specific to you may vary according to your age, other illnesses and the condition of your gallbladder, it is helpful to talk to your doctor in detail at the pre-operative consultation.

A large proportion of patients get up on the evening of the day of the operation and begin taking fluids. The hospital stay is usually short; for suitable patients, day-case discharge or an overnight stay may be possible. This decision is made according to the course of the operation and your general health.

In the first days, mild pain at the incision sites and shoulder pain due to the gas introduced into the abdomen may occur; these symptoms usually ease within a few days. It is sufficient to follow the advice given at discharge regarding wound care, when to bathe and the follow-up of stitches.

• People with desk jobs can mostly return to work within 1-2 weeks; for jobs requiring heavy lifting this period may be longer.
• It is generally recommended to avoid heavy lifting and strenuous exercise for a few weeks.
• The time of your follow-up examination will be given to you at discharge.