What is open cholecystectomy?
During the operation, the gallbladder is removed completely through an incision in the front of the abdominal wall.
The method is used for:
- severe acute cholecystitis
- gangrenous or perforated cholecystitis
- Mirizzi syndrome
- a marked inflammatory mass
- dense adhesions
- suspected or confirmed gallbladder cancer
- the need to perform other open abdominal operations at the same time
Our approach
At MSI, *our first choice is to perform cholecystectomy laparoscopically*, as it is the modern international standard of care.
Open surgery is performed only when it ensures maximum patient safety or allows the disease process to be eliminated radically.
Before the procedure, a comprehensive examination is carried out, which may include:
- ultrasound
- laboratory tests
- CT or MRCP
- assessment of liver and bile duct function
With complex anatomy or severe inflammation, we follow modern principles of safe biliary surgery and, if necessary, use *subtotal cholecystectomy* techniques as an alternative to risky dissection.
Postoperative treatment follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
When is surgery needed?
Open cholecystectomy is performed for:
- severe acute cholecystitis
- gangrene or perforation of the gallbladder
- Mirizzi syndrome
- empyema of the gallbladder
- suspected gallbladder cancer
- extensive adhesions
- cases where a laparoscopic operation cannot be completed safely
Indications for surgery
Surgery is recommended for:
- complicated forms of gallstone disease
- destructive cholecystitis
- severe local inflammation
- a high risk of injury to the main bile ducts during laparoscopy
- gallbladder tumors
How is the operation performed?
The procedure is performed under general anesthesia.
The abdominal cavity is explored through a laparotomy or subcostal incision. After the structures of Calot's triangle are dissected, the cystic artery and cystic duct are ligated and the gallbladder is removed.
In difficult cases, a subtotal cholecystectomy or additional reconstructive procedures on the bile ducts may be performed.
If malignancy is suspected, the extent of the operation is determined in line with oncological principles.
The removed gallbladder is sent for histopathological examination.
Advantages of open surgery
- Maximum safety with complex anatomy
- Treatment of severe forms of cholecystitis
- Better control of bleeding
- Combined operations are possible
- Radical treatment of gallbladder tumors
- Reliable treatment with massive adhesions
Recovery after surgery
Postoperative treatment follows *ERAS* principles.
The length of the hospital stay depends on the severity of the disease and the extent of the procedure. Recovery after open surgery takes longer than after laparoscopic cholecystectomy, but in difficult clinical situations this approach provides the safest treatment.
Our advantages
- Extensive experience in treating complex gallbladder disease
- A commitment to laparoscopic surgery whenever possible
- Open procedures for the most complex clinical situations
- Adherence to EAES, SAGES, Tokyo Guidelines, and WSES international recommendations
- Use of modern safe cholecystectomy techniques
- Enhanced recovery program (ERAS)
Frequently Asked Questions
With severe inflammation, Mirizzi syndrome, suspected cancer, or dense adhesions, open cholecystectomy may be safer than laparoscopic surgery.
No. If there is a high risk of bile duct injury or bleeding during laparoscopy, *conversion* to open surgery is the right and safe decision.
Yes. After open cholecystectomy, full recovery usually takes *4--6 weeks*, depending on the extent of the operation and the patient's general condition.
Yes. After it is removed, bile flows directly from the liver into the intestine, and most patients return to their normal lifestyle.
In the first weeks, a gentle diet is recommended. After that, most patients can gradually return to their usual diet.