Lap Cholecystectomy


What Are Gallstones?

The gallbladder stores bile, a fluid made by the liver. Bile helps digest fats in the foods you eat. Gallstones form when certain substances in the bile crystallize and become solid. In some cases, the stones don’t cause any symptoms. In others, they irritate the walls of the gallbladder. More serious problems can occur if stones move into nearby ducts—such as the common bile duct—and cause blockages. This stops the flow of bile and can lead to pain, nausea, and infection.

Common Symptoms

Gallbladder problems can cause painful attacks, often after a meal. Some people have only one attack. Others have many. Common symptoms include:

  • Severe pain or aching in the upper abdomen, back, or right shoulder blade
  • A dull ache beneath the ribs or breastbone
  • Nausea, upset stomach, or vomiting
  • Jaundice (a buildup of bile chemicals in the blood), which causes yellowing of the skin and eyes, dark urine, and itching

Treating Gallstones

If your stones are not causing symptoms, you may choose to delay treatment. But if you’ve had one or more painful attacks, your doctor will likely recommend removing your gallbladder. This prevents more stones from forming and causing attacks. It also helps prevent complications, such as stones passing into the ducts and causing infection or pancreatitis. After the gallbladder is removed, your liver will still make bile to aid digestion.

Cholecystectomy is surgical removal of the gall bladder. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallstones unless there are contraindications to the laparoscopic approach. Sometimes a laparoscopic cholecystectomy will be converted to an open cholecystectomy for technical reasons or safety.

Laparoscopic cholecystectomy requires several small incisions in the abdomen to allow the insertion of surgical instruments and a small video camera.With the abdomen insufflated and laparoscopic visualization, the gallbladder is separated from liver bed and removed through one of the small incisions.

Laparoscopic cholecystectomy does not require the abdominal muscles to be cut, resulting in less pain, quicker healing, improved cosmetic results, and fewer complications such as infection. Most patients can be discharged on the same or following day as the surgery, and most patients can return to any type of occupation in about a week.

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Anish Nihalani, MD, FACS
98 James Street
Suite 103
Edison, NJ 08820