Gallstone Surgery (Laparoscopic Cholecystectomy)

What is a laparoscopic cholecystectomy?

Gallstones that cause symptoms are treated by removing the gallbladder — stones and all — through keyhole surgery: four small incisions, a camera, and the gallbladder freed from the liver and lifted out. The liver keeps making bile, which simply flows directly into the intestine; the gallbladder is a reservoir most people never miss. More on gallstone symptoms sits on the general surgery page.

Who it may suit

Surgery is advised once gallstones declare themselves: biliary colic — the classic gripping pain under the right ribs after meals, often at night — acute cholecystitis (infection of the gallbladder), gallstone pancreatitis, or stones that have migrated into the bile duct. After a first attack, further attacks become likely, and each carries the risk of arriving as an emergency. Incidentally found stones that have never caused symptoms usually need no surgery at all — an honest distinction worth making.

What the procedure involves

• Performed under general anaesthesia; usually day surgery or one night in hospital
• The cystic duct and artery are identified and secured before anything is divided — the discipline that protects the main bile duct
• Conversion to an open operation is uncommon but always a possibility when inflammation obscures the anatomy; it is a safety decision, not a failure
• Most patients are eating the same day and back to desk work within a week

What to expect afterwards

Shoulder-tip discomfort from the laparoscopy gas is common for a day or two. Loose stools in the early weeks affect a minority and usually settle. Recognised risks — bleeding, bile leak, injury to the bile duct — are uncommon, but they are the reason this operation deserves an experienced, unhurried approach rather than a race.

Is it right for me?

If you have had one attack of gallstone pain, the useful question is not whether it was bad enough, but whether you want the next one to pick its own timing. At consultation the scans are reviewed, and I go through the case for surgery — or for leaving well alone — as it applies to your stones.