Upper GI Conditions


Cholecystectomy means removing the gallbladder (with its stones) and laparoscopic means the 'key hole' method of operation.

Why do you remove the whole gallbladder and not just the stones?

When the gallbladder form stones, it is diseased and will tend to keep forming more stones if just the stones are removed and it is left in the body.  As it has no obvious vital role in the body, the whole gallbladder is thus removed to cure the problem.


What do I need to know about the operation?

The operation is performed under a General Anaesthetic so you need to be medically fit enough to have the anaesthetic.  It usually takes an average of one hour to perform the operation, maybe much quicker if it is straightforward.  It is often done now as a day case procedure (ie you are in and out of the hospital on the same day) or often as an overnight stay in hospital. 


Instead of a big cut in the abdomen (as it used to be done before 1990), the gallbladder is now removed via 3 to 4 key hole incisions (about 1/4 to 1/2 inch or 5 to 10mm).  This is much less painful and hence recovery is much quicker after the operation.


In many instances a cholangiogram is added to the operation.  This is an XRay taken during the operation, with injection of a iodine-based 'dye' to show up the liver ducts to make sure that no stones have fallen out of the gallbaldder and travelled into the liver.  It can also help clarify the anatomy to ensure no injury occurs to the liver during the operation. If you are allergic to Xray dyes or iodine, please let your surgeon know of this as you will not be able to have this test.

What are the risks of the operation?

This operation is a commonly performed operation with a good safety record but there are some risks and complications which can occur.


Bruising around the wound site is common and can even spread quite a way in some cases.  Mostly nothing needs to be done and the bruising disappears over about 2 weeks.

Bleeding from the wound is less common and can often be controlled by pressure on the wound(s) for 5 minutes.  Actual rapid bleeding either from the wound or internally is rare (<1%) and may require a second operation to control the bleeding.

Wound infection - Infection of wounds can occur anytime a cut is made on the skin but is much less common with key hole surgery.  An infection may occur in the cut near the umbilicus as that is where the gallbladder will be extracted.  However, any infection has usually arisen from your own bacteria and is usually easily treated with antibiotics prescribed by your GP.  Most surgeons will give you a single dose of antibiotics during the operation to prevent infection.  On rarer occasions, the wound may need to be opened up and dressed daily if there is a lot of pus in it. 


Conversion to laparotomy - sometimes it is impossible or too difficult or dangerous to continue with a key hole operation, for example, if the gallbladder is very diseased and stuck down, and it may be necessary to make a big cut to finish the operation.  This occurs in about 1 in 100 people (1%) and your surgeon should be able to tell you how likely it may occur in you.  If this occurs, then it will mean you will stay in hospital an extra 2 to 5 days on average but is unlikely to have an long term impact.

Deep venous thrombosis - Clots in the legs can occur when a person is lying still whilst being operated on and /or does not move around as much as usual after the operation.  You should be given special compression stockings (TED) to wear for the operation and post-operatively and usually be given a little injection whilst in hospital to thin the blood down to prevent this happening.  You will also be asked to move around out of bed the next day to prevent this happening.


Injury to the liver and liver ducts - This is a very rare complication and should not occur if you have a good surgeon and your liver and gallbladder anatomy is normal.  The gallbladder is very closely related to the liver but most surgeons who are careful will not ever have  had this injury occur.  It is quoted in the literature as occuring about less 0.05% of all gallbladder operations and is mentioned as it is a serious problem.