CHOLECYSTECTOMY

 A cholecystectomy (koh-luh-sis-TEK-
tuh-me) is a surgical procedure to
remove your gallbladder — a pear-
shaped organ that sits just below
your liver on the upper right side of
your abdomen. Your gallbladder
collects and stores bile — a digestive
fluid produced in your liver.
 A cholecystectomy is a common surgery, and it carries only a small risk of
complications. In most cases, you can go home the same day of your
cholecystectomy.
 A cholecystectomy is most commonly performed by inserting a tiny video camera and
special surgical tools through four small incisions to see inside your abdomen and
remove the gallbladder. Doctors call this a laparoscopic cholecystectomy.
 In some cases, one large incision may be used to remove the gallbladder. This is
called an open cholecystectomy.

Indications

 Gallstones in the gallbladder (cholelithiasis)

 Gallstones in the bile duct (choledocholithiasis)
 Gallbladder inflammation (cholecystitis)
 Large gallbladder polyps
 Pancreas inflammation (pancreatitis) due to gallstones

Contraindications

 Inability to tolerate general anesthesia

 Uncontrolled coagulopathy.
 Patients with severe obstructive pulmonary disease
 Patients with congestive heart failure (eg, cardiac ejection fraction <20%)

2 types of Cholecystectomy Procedures

1. Minimally invasive (laparoscopic) cholecystectomy

 During a laparoscopic cholecystectomy, the surgeon makes four small incisions
in your abdomen. A tube with a tiny video camera is inserted into your abdomen
through one of the incisions. Your surgeon watches a video monitor in the
 operating room while using surgical tools inserted through the other incisions in
your abdomen to remove your gallbladder.
 Next you may undergo an imaging test, such as an X-ray or ultrasound, if your
surgeon is concerned about possible gallstones or other problems in your bile
duct.
 A laparoscopic cholecystectomy takes one or two hours.
 A laparoscopic cholecystectomy isn't appropriate for everyone. In some cases
your surgeon may begin with a laparoscopic approach and find it necessary to
make a larger incision because of scar tissue from previous operations or
complications.
2. Traditional (open) cholecystectomy
 During an open cholecystectomy, the surgeon makes a 6-inch (15-centimeter)
incision in your abdomen below your ribs on your right side. The muscle and
tissue are pulled back to reveal your liver and gallbladder. Your surgeon then
removes the gallbladder.
 The incision is sutured, and you're taken to a recovery area. An open
cholecystectomy takes one or two hours.