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Procedure definition

A cholecystectomy is the operation to remove your gallbladder, a small pear-shaped organ under the liver that stores bile. Most are done laparoscopically—through 3–4 tiny incisions in the abdomen using a camera and thin surgical instruments. The surgeon seals and divides the duct and artery that attach the gallbladder to the liver, then removes the organ through one of the small openings. This “keyhole” approach leaves minimal scarring and usually allows you to go home the same day.

In some cases, especially when there is severe inflammation, scarring, or unclear anatomy, the operation is converted to a traditional open cholecystectomy, which uses a single incision (4–6 inches long) under the ribs on the right side. Only about 3–10% of laparoscopic cases require conversion.

The surgery usually takes 45–90 minutes. Laparoscopic removal has become the worldwide standard because it reduces pain, hospital time, and recovery length compared with older open methods.

Why it’s done

The most common reason for gallbladder removal is gallstones—hard deposits that block bile flow and cause pain known as biliary colic. You might feel this pain in the upper right abdomen or shoulder after fatty meals. Other reasons include:
• Acute cholecystitis—infection or inflammation of the gallbladder wall.
• Gallstone pancreatitis—when stones block the duct leading to the pancreas.
• Choledocholithiasis—stones in the main bile duct (often treated at the same time).
• Gallbladder polyps larger than 1 cm, which can sometimes become cancerous.
• Functional gallbladder disease (biliary dyskinesia) confirmed by testing when pain persists without stones.

For most attacks of gallbladder inflammation, experts recommend early surgery—ideally within 72 hours—because this shortens total illness time and lowers the risk of complications from repeat episodes. Elective surgery is also recommended if stones have caused repeated discomfort or have moved into the bile duct.

Risks & complications (with numeric ranges)

Cholecystectomy is considered a safe and routine procedure, but—as with any surgery—complications can occur. Overall complication rates range from 2–8% in large national studies, with major complications in 1–3% of patients.

Common or minor issues: temporary shoulder pain from gas used during laparoscopy (15–30%), mild bloating or diarrhea (5–10%), and small wound bruising or infection (1–3%).

Less common but serious complications:
• Bile duct injury (BDI): 0.2–0.5% — accidental damage to the main bile duct; may need additional repair surgery.
• Bile leak: 0.3–2%.
• Bleeding: 0.1–2%.
• Intra-abdominal abscess or infection: 0.1–1%.
• Retained stone in the bile duct: 0.5–2%.
• Conversion to open surgery: 3–10%.
• Death (all causes): 0.1–0.3% in elective cases, up to 1–2% in elderly or emergency patients.

Surgeons follow strict safety steps, such as confirming the “Critical View of Safety” before cutting any ducts and using imaging (cholangiography) when anatomy is unclear. These steps have reduced serious bile-duct injuries dramatically.

Recovery

Hospital stay: Most laparoscopic patients go home the same day or after one night. Open surgery patients stay about 2–3 days.

Activity: You can usually walk the same day. Light household activities start within a few days; driving when off pain pills; desk work in 1–2 weeks; heavier work or exercise after 3–4 weeks.

Diet: You can resume eating soon after surgery. Some people prefer a low-fat diet for a few weeks to minimize digestive discomfort. The body adapts to living without the gallbladder; bile flows directly from the liver to the intestine. Persistent diarrhea affects about 5–10% of people but typically improves within weeks.

Wound care: Small incisions usually heal in 5–7 days; glue or dissolving stitches are common. Watch for redness, drainage, or fever.

Follow-up: Most surgeons see patients once 1–2 weeks post-op. You can expect full recovery in 2–4 weeks (laparoscopic) or 4–6 weeks (open).

Surgeon types

Performed primarily by board-certified General Surgeons who routinely do laparoscopic operations. Complex or high-risk cases—severe inflammation, distorted anatomy, bile-duct stones, or suspected gallbladder cancer—may be referred to a Hepatobiliary (HPB) surgeon or an advanced gastrointestinal surgeon with specialized training in liver and bile-duct anatomy. Pediatric cases are handled by Pediatric Surgeons.

Outcomes improve with experience: surgeons and hospitals performing >100 cholecystectomies per year show significantly fewer conversions and bile-duct injuries compared with low-volume providers.

Representative citations

1. SAGES Safe Cholecystectomy Multi-Society Guideline (2020) — reports bile-duct injury 0.2–0.5% and safety steps.
2. NIH MedlinePlus: “Laparoscopic Gallbladder Removal” — overview of risks and recovery.
3. American College of Surgeons (ACS): “Cholecystectomy—Benefits and Risks” — patient education summary.
4. Bingener et al., Annals of Surgery (2018): US cohort; morbidity 4–6%, mortality <0.3%.
5. NHS Inform (UK): Patient leaflet, postoperative diet and activity guidance.