cholecystectomies

Cholecystectomy is a surgical procedure to remove the gallbladder, most often to treat symptomatic gallstones (cholelithiasis) and gallbladder inflammation (cholecystitis). It may also be performed for gallbladder polyps, porcelain gallbladder, biliary dyskinesia, or stones in the bile ducts when removal is indicated. The operation aims to prevent recurrent symptoms and complications from stones or inflammation.

Two main approaches are laparoscopic cholecystectomy and open cholecystectomy. Laparoscopic cholecystectomy is the standard method in most settings. It uses several small incisions, a camera, and instruments to detach the gallbladder from the liver bed and divide the cystic duct and cystic artery before removing the gallbladder. Most patients are discharged within 24 hours or after a short hospital stay. If the anatomy is unclear or complications occur, surgeons may convert to an open procedure through a larger incision. Robotic-assisted or single-incision techniques are reported at some centers. Open cholecystectomy, via a right subcostal incision, is slower to recover and is reserved for complex cases or when laparoscopy is not feasible.

Before surgery, imaging (usually ultrasound) confirms stones and anatomy; further imaging (MRCP or ERCP) may be used if duct stones are suspected. In acute cholecystitis, surgery is often urgent; in other cases it is elective. Non-surgical options are limited and include dissolution therapy or endoscopic removal for certain bile duct stones, but are not definitive.

Risks include injury to the bile ducts, bleeding, infection, and hernias at incision sites; bile leak and retained stones can occur. Overall, cholecystectomy has a high success rate with rapid recovery for most patients.