Choose the topic you want to read.
- Laparoscopic cholecystectomy
- Why laparoscopic cholecystectomy?
- What are the symptoms of gallstone?
- What is the risk factor for gallstones?
- What is a laparoscopic cholecystectomy procedure?
- What is the advantage of laparoscopic cholecystectomy?
- What is the complication of laparoscopic cholecystectomy?
Laparoscopic cholecystectomy
Laparoscopic cholecystectomy is a minimally invasive surgical procedure that involves using a laparoscope to remove gallbladder and gallstones at once, the causes of epigastric pain include bloating, distension, yellowing of the skin and eyes (jaundice), nausea, and vomiting. Long-term untreated gallstones can result in serious complications such as gallbladder infection, acute cholecystitis, bile duct stricture, or even gallbladder cancer. Laparoscopic cholecystectomy (LC) treats gallstone disease effectively, leaving just tiny surgical incisions, reducing post-operative complications, shortening the recovery period, and removing gallstones and gallstones permanently.
Why laparoscopic cholecystectomy?
In the past, gastrointestinal surgeons treated gallstones with an open cholecystectomy surgical procedure diagonally on the lower edge of the right ribcage, or vertically in the middle of the epigastric region to remove gallbladder and gallstones, resulting in a large surgical incision of approx. 10 cm. with long slow-healing scars, losing more blood, intense postoperative pain, and prolonged hospital stay.
Laparoscopic cholecystectomy uses a minimally invasive surgery (MIS) technique, leaving only tiny incisions of approx. 0.5-1 cm, allowing surgical wounds to heal quickly, losing less blood, causing less pain, and requiring only a 1–2-day hospital stay.
What are the symptoms of gallstone?
- Epigastric pain, colicky pain, and tenderness under the right ribcage which may radiate to the right shoulder blade or right shoulder.
- A series of epigastric pain that comes and goes over several hours, particularly after eating a high-fat meal.
- Epigastric pain worsened to the point of doubling over, bloating, and stomach tightness.
- Severe epigastric pain, localized tenderness when pressed under the right rib cage, fever, chills, intermittent nausea, and vomiting.
- Severe epigastric pain, high fever, jaundice (yellowing of the skin and eyes), dark urine, and pale white stools.
- Bitter taste in the mouth, metallic taste in the mouth (Dysgeusia), difficulty swallowing, severe sore throat, loss of appetite.
What is the risk factor for gallstones?
- Eating high-fat, high-cholesterol foods
- Obesity or overweight
- Those aged 40 and up
- Rapid weight loss
- Taking certain fat-reducing drugs
- Some types of anemia, such as thalassemia
- Genetics: a family history of gallstones.
- Diabetes, increased cholesterol or triglyceride levels
- Those who take estrogen pills or higher estrogen levels during pregnancy
Binary tract and pancreatic diseases can be treated with laparoscopic cholecystectomy
- Gallstones
- Choledocholithiasis
- Cholangitis
- Bile duct stricture
- Acute cholecystitis
- Pancreatitis
- Bile duct tumor
- Gallbladder cancer
What is laparoscopic cholecystectomy procedure?
Laparoscopic cholecystectomy (LC) at MedPark Hospital adopts an international gold standard of minimally invasive surgery (MIS) for treating gallstone diseases, prioritizing patient safety, and treatment success. Our post-operative procedure is one of the utmost concerns, our gastroenterologists and a multidisciplinary team will conduct periodic physical assessments to ensure the treatment outcomes are satisfactory, free of complications, and enable a positive recovery.
Pre-operative laparoscopic cholecystectomy
- The gastroenterologist will conduct a thorough history, physical examination, blood tests, and an upper abdominal ultrasound to check for gallstones or other abnormalities in the biliary tract and pancreas followed by assessing the patient's physical readiness before the surgery.
- Individuals with a history of allergic reactions to any type of medication *must notify the gastroenterologist in advance.
- Refrain from drinking, eating, and smoking for at least 6 hours before surgery.
During laparoscopic cholecystectomy
- The gastrointestinal surgeon and nurses prepare the patient by administering intravenous (IV) fluids. The anesthesiologist will then administer general anesthesia to sedate you to sleep.
- The gastrointestinal surgeon will pierce tiny keyhole incisions through the abdominal wall in 4 locations: A 1 cm. incision on the navel is made for inserting a high-definition laparoscope to project a clear visualization of the internal organs, then a trocar port and CO2 gas are insufflated to create a working space in the abdomen and lift the abdominal wall for better visualization. Another three 0.5 cm incisions are made on different parts of the abdominal wall for inserting surgical instruments.
- The gastrointestinal surgeon inserts trocar ports and laparoscopic surgical instruments into the gallbladder to remove it from the liver and common bile duct, then uses sutures or endoclips to tie the neck of the gallbladder before cutting the entire gallbladder from the tissue located beneath the liver. The gastrointestinal surgeon then removes the gallbladder and the remaining tissues out through the navel, cleans the surgical wounds, and securely stitches the wound. If there is severe inflammation, the gastrointestinal surgeon will insert a drainage catheter to drain blood and lymph for 2-3 days in cases of severe inflammation.
- In severe, complicated cases, such as gallbladder pus or severe cholecystitis, a swollen gallbladder, a lot of intraperitoneal adhesions, or bile leakage into the abdominal cavity, the gastrointestinal surgeon will consider a prompt intervention with open cholecystectomy rather than laparoscopic cholecystectomy.
- Once the laparoscopic cholecystectomy procedure is over. The gastrointestinal surgeon will periodically assess symptoms and vital signs. Typically, the LC procedure takes approximately 60-90 minutes.
Post-operative laparoscopic cholecystectomy
- The gastrointestinal surgeon will have the patient recover in the hospital for 1-2 days to monitor symptoms after surgery, including the prevention of complications such as infection, blood clots, pancreatitis, nausea, or vomiting caused by general anesthesia.
- After the operation, the gastroenterologist will provide oral pain relievers to relieve aches and IV fluids to alleviate wound pain. If no abnormalities are detected, the gastrointestinal surgeon will allow the patient to take sips of water, eat soft food, and return home.
- Typically, the surgical wound from laparoscopic cholecystectomy will gradually heal within 2 weeks. Patients are expected to meet with the gastroenterologist on the scheduled day and time to follow up on symptoms after the surgery.
What is the advantage of laparoscopic cholecystectomy?
- Tiny surgical wound, less painful, faster recovery, and ability to resume normal activities quickly.
- Minimally invasive, low blood loss, low infection rate.
- Less tissue damage, less internal organ injuries.
- The surgery takes approx. only 60-90 minutes.
- The treatment outcome is equivalent to open surgery.
- The length of the hospital stay is only 1-2 days. (Open surgery requires a 7–10-day hospital stay).
- A short recovery period of approx. 1 week (Open surgery requires 1 month to recover).
- Reduce the risk of complications in seniors, vulnerable, or those with underlying diseases.
- Effectively treat tumors, intraperitoneal adhesions, or early-stage cancer promptly.
- Significantly improves a patient’s quality of life.
What is the complication of laparoscopic cholecystectomy?
Laparoscopic cholecystectomy (LC) is regarded as a very safe surgical procedure, with a complication rate of less than 2% and few effects on the internal organs. After the surgery, patients can recover quickly and resume their daily lives rapidly. The complications of laparoscopic cholecystectomy are as follows:
- Bleeding is common in 0.1-1.9% of cases, usually occurring in the hepatic portal vein or cystic duct and frequently during surgery. The gastrointestinal surgeon will stop the bleeding using standard procedures. However, in rare cases of hard-to-control arterial bleeding, the gastrointestinal surgeon may proceed with open surgery to keep blood pressure levels normal.
- Infections: Surgical wound infections affect 3-5% of patients and typically occur within the first 2-3 days after surgery. Most infections are mild, and the gastrointestinal surgeon can cure them with antibiotics.
- Biliary leaks occur in less than 2% of cases, can originate in the gallbladder bed, or major bill duct, and are typically detected after the surgery. If biliary leaks are detected, the gastrointestinal surgeon may consider an open surgery, laparoscopic cholecystectomy, or endoscopic biliary stent placement as appropriate.
Laparoscopic cholecystectomy at MedPark Hospital
Surgical Clinic at MedPark Hospital, Bangkok, Thailand is led by a team of leading gastrointestinal and biliary surgeons who are fully prepared to provide second-to-none diagnostic and therapeutic for difficult and complex biliary tract and pancreatic diseases using JCI standard ERCP, open surgery, or laparoscopic cholecystectomy (LC), enabling minimal incisions, less painful, and a quick recovery integrated with state-of-the-art medical technology and equipment with advanced medical techniques, ensuring safe, fast, and precise treatment, contributing to treatment efficiency while providing follow-up and evaluation after the surgery to ensure the patient is safe from complications, recovers quickly, have a good quality of life, and are physically healthy.
FAQ
- What is the recovery time for a laparoscopic cholecystectomy?
Laparoscopic cholecystectomy requires about 1 week of recovery time at home, after which patients can resume normal work and their daily routine as usual. For those, the gastrointestinal surgeon leaves a drainage catheter to drain blood and lymph, they will remove it at the first post-surgery checkup. However, lifting heavy objects or engaging in strenuous exercise should be avoided for at least 2 weeks to allow your body to recover fully.
