Cholecystectomy

What is a cholecystectomy?

Cholecystectomy is the surgical removal of the gallbladder. Your doctor may recommend a cholecystectomy if you develop gallstones (cholelithiasis) that can cause pain. The gallbladder is located in the upper right side of your abdomen under the liver. The pear-shaped gallbladder is a hollow sac that concentrates and stores bile produced by the liver. Bile moves from the gallbladder through the bile duct into the small intestine during digestion. A gallstone can move from the gallbladder and block a bile duct, causing irritation, pain and swelling of the gallbladder (cholecystitis).

Cholecystectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options and should consider getting a second opinion about all of your treatment choices before having a cholecystectomy.

Types of cholecystectomy

The types of cholecystectomy include:

• Laparoscopic cholecystectomy, which involves removing your gallbladder through several small incisions. Your surgeon will use a laparoscope, a thin, lighted instrument with a small camera that transmits pictures of the inside of your body to a video screen. Your doctor sees the surgical area on the video screen while removing your gallbladder using surgical instruments adapted for laparoscopic surgery.  This is the most commonly performed method of removing your gallbladder.
• Open cholecystectomy, which involves making a larger incision that allows your doctor to directly see and remove the gallbladder.

Other procedures that may be performed

In addition to a cholecystectomy, your doctor may recommend one or more procedures to diagnose or treat certain conditions. Other procedures may include:

• Endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to locate and remove a gallstone that is stuckin the major bile duct. In ERCP, your doctor will use an endoscope. An endoscope is a long, lighted instrument that contains a camera to transmit pictures of the inside of your body to a video screen during surgery. Your doctor will pass the endoscope down your throat and through the stomach into the small intestine. Your doctor will remove the stone through the endoscope.
• Laparoscopic transcystic common bile duct stone extraction, another procedure used to locate and remove a gallstone that is stuck in the bile duct. In this surgery, your doctor will insert surgical instruments through small abdominal incisions and remove the stone through the bile duct with a small basket.

Why is a cholecystectomy performed?

A cholecystectomy is a major surgery that you doctor may recommend to treat diseases and conditions of the gallbladder, and sometimes the pancreas. Your doctor may only consider cholecystectomy if other treatment options that involve less risk of complications have been ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

A cholecystectomy is a surgery that your doctor may recommend to treat the following conditions:

• Cholecystitis, which is inflammation of the gallbladder resulting in severe pain called biliary colic. A gallstone that gets stuck in a bile duct that carries bile to or from the gallbladder causes cholecystitis.
• Choledocholithiasis, which is a gallstone that moves into the bile duct. In some cases, the gallstone will pass by itself. If it gets stuck in the bile duct it can cause inflammation of the gallbladder and possibly the pancreas.
• Cholelithiasis (gallstones) in the gallbladder, if they cause frequent or severe pain
• Gallstone pancreatitis, which isinflammation of the pancreas caused by a gallstone that gets stuck in the bile duct. The stone can also block the pancreatic duct. The pancreatic duct carries digestive juices from the pancreas.
• Perforated gallbladder, which is leaking or bursting of the gallbladder
• Gallbladder cancer, a rare cancer