What is Laparoscopic Cholecystectomy and Why Would I Need It?


If you are experiencing severe gallstone attacks, there is a good chance your Baltimore gallbladder surgeon will want to remove your entire gallbladder.

Although complete removal of the gallbladder is often a last resort option because no other treatment plans are working, or the pain you are having due to gallstones is unbearable, the surgery is actually routine.

However, this does not mean there are no risks or complications associated with such a complex surgery.

Today we are going to look at how your gallbladder surgeon might remove your gallbladder using the popular surgical method called a laparoscopic cholecystectomy.  We will discuss the nature of the procedure, as well as list any complications that may arise during a laparoscopic cholecystectomy procedure.


What is a Laparoscopic Cholecystectomy?

Removing your gallbladder entails a procedure called a cholecystectomy.

In the past, your gallbladder was removed via a 5-8 inch long incision in your abdomen made just under your rib cage in the right side.  Called an open cholecystectomy, this procedure was very invasive and often presented several complications and long recovery periods.

In response, a newer and less invasive technique was developed called a laparoscopic cholecystectomy.

Rather than cutting into your abdomen as explained above, during a laparoscopic cholecystectomy procedure a small instrument called a laparoscope is used to remove your gallbladder.

This is done through four small incisions, approximately 1 inch in length, rather than the one large incision.  Of course, you are under general anesthesia during this time.

In addition, during the surgery your surgeon may looking within your common bile duct to detect any gallstones that may have become lodged in there.  It is important to remove these for a complete recovery and to prevent further inflammation and complications related to the gallstones.


What is a Laparoscope?

baltimore-laparoscopic-cholecystectomy-gallstone-surgeryA laparoscope is a small, thin tube that is placed into your body through a small incision made just above your belly button.  It allows your gallbladder surgeon to view the inside of your abdominal cavity on a television screen thanks to the small camera and light on the end of the laparoscope.

In addition, your abdomen is inflated with air or carbon dioxide making visibility clearer for the physician operating on you.  This way all of your internal organs and tissues can be viewed easily during the operation.

Using the laparoscope as a guide, your surgeon will then remove your gallbladder through one of the other three incisions made in your abdomen.  This surgery requires an expert surgeon specially trained in performing laparoscopic cholecystectomies.

While it may be rather routin, and can be completed in a little less than an hour under ideal conditions, the gallbladder is a small organ surrounded by several important organs and tissues that must be considered as the gallbladder is cut away and removed from your body.


What to Expect During a Laparoscopic Cholecystectomy

Since laparoscopic cholecystectomy procedures are less invasive than the traditional open cholecystectomy, you will experience several benefits post-surgery:

  • Shorter hospital stay, sometimes leaving the same day as your surgery
  • Less pain during recovery
  • Speedier recovery time
  • Quicker return to normal activities such as work
  • Less abdominal pain/loss of strength since a large incision was not performed

There are instances when your gallbladder surgeon may need to perform an open cholecystectomy on you to remove your gallbladder rather than perform the recommended laparoscopic cholecystectomy.  For example, if you previously had surgery on your gallbladder or in the surrounding area, if you tend to bleed a lot, or if there is some reason it may be hard for your surgeon to adequately see your gallbladder using the laparoscope, you may need to recovery to the open cholecystectomy instead.

In addition, there are times when a gallbladder surgeon begins a laparoscopic cholecystectomy on a patient and has to resort to an open cholecystectomy due to some complications during the surgery.  This happens in approximately 5-10 laparoscopic cholecystectomies in the United States.  Reasons for this include:

  • Unexpected inflammation of the surrounding area diminishing visibility
  • Excessive scar tissue making it difficult to maneuver through small incisions
  • Injury to the surrounding areas, including the common bile duct, during surgery


What is a Common Bile Duct Injury?

Occurring most frequently during a laparoscopic cholecystectomy procedure, a common bile duct injury happens when your gallbladder surgeon mistakenly cuts away at the common bile duct rather than the cystic duct.

Although this type of injury is very rare, happening in only one percent of all gallbladder surgeries, a serious laparoscopic cholecystectomy complication such as this needs addressing quickly during surgery.

Unfortunately, some common bile duct injuries unnoticed until sometime after the gallbladder surgery has been completed and the patient is in recovery.  Noticeable symptoms such as fever, chills, abdominal swelling, and pain tip off the physician that something is wrong.

Since laparoscopic cholecystectomy recovery times are supposed to be minimal, if you find yourself not recovering within the intended timeframe, it is important to see your gallbladder surgeon to make sure nothing serious is wrong.


Additional Risk Factors of a Laparoscopic Cholecystectomy

No surgery goes risk free, and laparoscopic cholecystectomies are no different.  The overall risk of a laparoscopic cholecystectomy procedure is relatively low.  However, some possible complications include:

  • Incision infections
  • Internal bleeding
  • Common bile duct injuries
  • Injury to the small intestine
  • General anesthesia risks
  • Gallstones remaining in the abdominal cavity
  • Bile leaks into the abdominal cavity
  • Injury to the abdominal blood vessels
  • Gallstones being pushed into the common bile duct and becoming lodged
  • The liver being cut

Though very rare, most of these laparoscopic cholecystectomy complications will require additional surgery to fix.  This then increases the risk of complications related to surgery and affects the overall status of your health.

If you find yourself needing a laparoscopic cholecystectomy, and are living in the Baltimore area, contact Dr. Fraiman to help you.  Specializing in laparoscopic cholecystectomies, and having extensive experience dealing with complications such common bile duct injuries, Dr. Fraiman has the knowledge to treat your gallbladder disease in an effective and individualized way.

Enlisting an interdisciplinary team of specialists to help him, Dr. Fraiman does not take his position as a gallbladder physician lightly.  He remains dedicated to every patient he has and understands that the quality of your health largely depends on him and his team.

Contact him today and see how he can help you regain your health in the most effective way possible.