Cholecystectomy (Gallbladder Removal)

What Is a Cholecystectomy?

A cholecystectomy removes the gallbladder, a small pear-shaped organ storing bile beneath the liver. Most procedures use laparoscopic techniques with 3-4 tiny incisions and a camera.

The surgeon seals the gallbladder's connecting duct and artery, then removes it through one opening. This "keyhole" approach minimizes scarring and typically allows same-day discharge.

Traditional open cholecystectomy uses a single 4-6 inch incision under the right ribs. Approximately 3-10% of laparoscopic cases require conversion to open surgery. The operation typically lasts 45-90 minutes.

Why It's Done

Primary reason: Gallstones blocking bile flow cause pain (biliary colic), typically in the upper right abdomen or shoulder after fatty meals.

Other indications:

• Acute cholecystitis (gallbladder infection/inflammation)
• Gallstone pancreatitis (stones blocking the pancreatic duct)
• Choledocholithiasis (stones in the main bile duct)
• Gallbladder polyps larger than 1 cm
• Functional gallbladder disease with persistent pain

Expert recommendations favor early surgery within 72 hours for inflammation episodes, reducing total illness duration and repeat-episode risks.

Risks & Complications

Cholecystectomy is considered safe and routine. Overall complication rates range from 2-8%, with major complications occurring in 1-3% of patients.

Common minor issues:

• Temporary shoulder pain (15-30%)
• Mild bloating or diarrhea (5-10%)
• Wound bruising or infection (1-3%)

Serious complications:

• Bile duct injury: 0.2-0.5%
• Bile leak: 0.3-2%
• Bleeding: 0.1-2%
• Intra-abdominal abscess or infection: 0.1-1%
• Retained bile duct stone: 0.5-2%
• Conversion to open surgery: 3-10%
• Death (elective cases): 0.1-0.3%; higher in elderly or emergency patients (1-2%)

Recovery Timeline

• Hospital stay: Same day or one night for laparoscopic; 2-3 days for open surgery
• Walking: Same day
• Light household tasks: Within days
• Driving: When off pain medication
• Desk work: 1-2 weeks
• Heavy work/exercise: 3-4 weeks
• Full recovery: 2-4 weeks (laparoscopic) or 4-6 weeks (open surgery)

Diet: Most patients resume eating soon after surgery. Some prefer low-fat meals initially to minimize digestive discomfort. About 5-10% experience persistent diarrhea, typically improving within weeks.

Wound care: Small incisions heal in 5-7 days; watch for redness, drainage, or fever.

Surgeon Qualifications

Board-certified General Surgeons performing routine laparoscopic procedures typically handle cholecystectomies.

Complex cases—severe inflammation, distorted anatomy, bile-duct stones, or suspected cancer—may require Hepatobiliary surgeons or advanced gastrointestinal specialists. Pediatric cases go to Pediatric Surgeons.

Outcomes improve significantly with volume: surgeons and hospitals performing over 100 procedures annually show fewer conversions and bile-duct injuries than low-volume providers.