Laparoscopic Gallbladder Removal (Cholecystectomy) Patient Information from SAGES

What Preparation is Required for Laparoscopic Gallbladder Removal?

  • The following includes typical events that may occur prior to laparoscopic surgery; however, since each patient and surgeon is unique, what will actually occur may be different:
  • Preoperative preparation includes blood work, medical evaluation, and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
  • It is recommended that you shower the night before or morning of the operation. Your surgeon may also want you to use an antibiotic soap.
  • After midnight the night before the operation, you should not eat or drink anything. You may take medications that your surgeon has told you are permissible to take with a sip of water the
    morning of surgery.
  • Drugs such as blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E may need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need at home.
  • Do not shave your abdomen before surgery.

How is Laparoscopic Gallbladder Removal Performed?

  • Under general anesthesia, so the patient is asleep throughout the procedure.Common patient position for laparoscopic gallbladder removal
  • Using a cannula (a narrow tube-like instrument), the surgeon enters the abdomen in the area of the belly-button.
  • A laparoscope (a tiny telescope) connected to a special camera is inserted through the cannula, giving the surgeon a magnified view of the patient’s internal organs on a television screen.
  • Other cannulas are inserted which allow your surgeon to delicately separate the gallbladder from its attachments and then remove it through one of the openings.
  • An X-ray called a cholangiogram may be performed during the operation to identify stones which may be lodged in the bile channels or to verify the anatomy of structures that have been identified.
  • If the surgeon finds one or more stones in the common bile duct, he/she may remove them with a special scope, may choose to have them removed later through an endoscope placed through the mouth into the stomach using a procedure called ERCP or may convert to an open operation in order to remove all the stones during the operation.
  • After the surgeon removes the gallbladder, the small incisions are closed with absorbable stitches or with surgical tape or glue.

Steps for laparoscopic gallbladder removal

What Happens if the Gallbladder Removal Cannot Be Performed or Completed by the Laparoscopic Method?

In a small number of patients the laparoscopic method cannot be performed for gallbladder removal. Factors that may increase the possibility of choosing or converting to the “open” procedure may include a very inflamed and scarred gallbladder, obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.

The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather good surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

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Brought to you by:

SOCIETY OF AMERICAN GASTROINTESTINAL AND ENDOSCOPIC SURGEONS (SAGES)
11300 West Olympic Blvd., Suite 600
Los Angeles, CA 90064
Tel:
(310) 437-0544
Fax:
(310) 437-0585
E-Mail:
publications@sages.org
Revised:
March 1, 2015
This brochure is intended to provide a general overview of a surgery. It is not intended to serve as a substitute for professional medical care or a discussion between you and your surgeon about the need for a surgery. Specific recommendations may vary among health care professionals. If you have a question about your need for a surgery, your alternatives, billing or insurance coverage, or your surgeons training and experience, do not hesitate to ask your surgeon or his/her office staff about it. If you have questions about the operation or subsequent follow up, discuss them with your surgeon before or after the operation.