Laparoscopic cholecystectomy is most commonly performed to treat gallstones. It is also performed for some gallbladder polyps or when there is gallbladder sludge that is believed to have caused pancreatitis. Occasionally it may be performed when the gallbladder becomes inflamed in the absence of gallstones.

The gallbladder is a small organ that sits underneath the liver, just under the ribcage on the right side of the abdomen. It stores bile (a yellow liquid produced by the liver) and controls the flow of bile into the bowel. Bile carries waste from the liver and also helps digest food.

Removal of the gallbladder is almost always performed as a laparoscopic procedure nowadays. In some cases, an operation may need to be converted from a laparoscopic to an open operation through a single larger incision during the operation. The chance of this is <1% although may be greater when the gallbladder is severely inflamed (severe acute cholecystitis) or surgery is complex due to chronic inflammation from longstanding gallstone disease or adhesions from previous surgery.

Cholecystectomy involves disconnecting the gallbladder from the liver surface and dividing the duct that connects the gallbladder to the bile duct (the cystic duct). The gallbladder is placed in a small pouch and removed through one of the small incision sites. It is usual for a cholangiogram to be performed as part of the operation. This is a special XRay that involves placing a catheter in the cystic duct and injecting contrast into the bile duct, which is seen on the XRay. This is done to look for any stones that may have fallen out of the gallbladder into the bile duct. If stones are seen in the bile duct they can sometimes be retrieved with tiny baskets or pushed though into the duodenum (to safely pass in the stool) during surgery. If not, a separate ERCP procedure may be required to retrieve them.

Complications of cholecystectomy include

• Bleeding
• Bile leak
• Bile duct injury
• Diarrhoea
• Post cholecystectomy syndrome (abdominal symptoms such as pain)
• As well as general risks of surgery such as wound infections and blood clots in the legs (deep venous thrombosis) that can travel to the lungs (pulmonary embolism).

Most patients have no complications from laparoscopic cholecystectomy and go home the next morning. Recovery is usually quite rapid.