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Cholecystectomy: Types and Procedures

Cholecystectomy is a common surgical treatment performed to remove the gallbladder, due to symptomatic or recurring gallstones (accumulated bile and digestive fluid produced in the liver) and some other conditions affecting the gallbladder. There are two options for cholecystectomy, a minimally-invasive method known as cholecystectomy laparoscopic procedure, in which a tiny video camera and surgical tools are inserted into the abdomen through small incisions, and open cholecystectomy, a more invasive procedure in which a larger incision is used to remove the gallbladder.

Cholecystectomy procedure is a common operation, which carries small risk of complications, it is an urgent medical necessity when pain is experienced, caused by gallstones blocking the flow of bile.

Doctors will recommend cholecystectomy if a patient suffers from one of the following conditions:

  • Cholelithiasis or gallstones in the gallbladder
  • Choledocholithiasis or gallstones in the bile duct
  • Cholecystitis or gallbladder inflammation
  • Pancreatitis or pancreas inflammation

Risks of complications depend on the overall health of the patient and the reason of the cholecystectomy. Among the small number of risks we find:

  • Bile leak
  • Blood clots
  • Bleeding
  • Heart problems
  • Infection
  • Injury to nearby structures
  • Pancreatitis
  • Pneumonia

 The Cholecystectomy Procedure

A few days prior to cholecystectomy, the surgeon will ask the patient to drink a prescription solution to flush stool out from the intestines. Medications with water are allowed the night before the surgery, but it is important to avoid eating the day before. Additionally, some medications and supplements should be avoided if they carry a risk of bleeding.

Plan ahead the recovery period after surgery! This includes programming a hospital stay (if complications arise) and finding someone to drive you home and take care of you.

The cholecystectomy laparoscopic procedure or open cholecystectomy is performed under general anesthesia.

The minimally invasive procedure consists of four small incisions in the abdomen, and inserting a video camera and surgical tools, which the surgeon operates from  a monitor. Incisions in the abdomen are necessary to remove the gallbladder. After the procedure, imaging tests such as ultrasound and X-ray are performed to check for abnormalities in the bile duct and to detect remaining gallstones. Incisions are sutured and the patient is taken to the recovery unit. Cholecystectomy laparoscopy takes no more than two hours.

On the other hand, the more traditional procedure open cholecystectomy, requires a six-inch incision below the ribs in order to pull back muscles and tissue, and find the gallbladder to be removed.

The reason you can not have a laparoscopic cholecystectomy and need to undergo the long process is due to the individual’s anatomical structure of the abdomen. Usually the doctor knows it only when the patient is having the operation and not beforehand. Prior to the operation, you are required to sign a consent form, agreeing that if the doctor is not able to perform the laparoscopic method,  he will have to open up the abdomen.

Recovery time depends on the type of procedure: cholecystectomy laparoscopy necessitates an overnight hospitalization and recovery takes about a week and open cholecystectomy takes five weeks to fully recover.

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