What is laparoscopic cholecystectomy?
During the operation, the gallbladder is removed completely together with its contents.
The procedure is performed for:
- gallstone disease
- chronic calculous cholecystitis
- acute cholecystitis
- gallbladder polyps
- adenomyomatosis
- certain functional gallbladder disorders
- suspected malignancy (in selected cases)
After the gallbladder is removed, bile continues to flow directly from the liver into the intestine.
Our approach
At MSI, gallbladder diseases are treated in line with guidelines from the *EAES, SAGES, the Tokyo Guidelines, and the WSES*.
Before surgery, the patient undergoes a comprehensive examination, which may include:
- ultrasound
- laboratory tests
- MRCP or CT, when indicated
- consultation with related specialists
We aim to perform cholecystectomy laparoscopically in all patients when it is safe and technically feasible.
During the operation, we strictly follow the *Critical View of Safety (CVS)* principle, the international standard for preventing bile duct injury.
When needed, *intraoperative fluorescent cholangiography with ICG* is used, which improves visualization of the bile ducts and increases the safety of the procedure.
In difficult cases (severe inflammation, Mirizzi syndrome, dense inflammatory mass), the extent of the operation is determined individually.
Postoperative treatment follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
When is surgery needed?
Laparoscopic cholecystectomy is performed for:
- symptomatic gallstone disease
- chronic calculous cholecystitis
- acute cholecystitis
- gallbladder polyps larger than 10 mm
- rapidly growing polyps
- adenomyomatosis
- porcelain gallbladder
- certain cases of asymptomatic gallstone disease
Indications for surgery
Surgery is recommended for:
- repeated attacks of biliary colic
- acute or chronic cholecystitis
- complications of gallstone disease
- large or suspicious polyps
- a risk of gallbladder cancer
- gallbladder dysfunction with clinical symptoms
How is the operation performed?
The procedure is performed under general anesthesia.
Laparoscopic instruments and a camera are inserted through 3--4 small punctures. After the structures of Calot's triangle are dissected and the *Critical View of Safety* is achieved, the cystic duct and cystic artery are clipped and divided.
The gallbladder is separated from the liver bed and removed through one of the trocar sites.
If necessary, intraoperative cholangiography is performed or fluorescent navigation with ICG is used.
The removed gallbladder is always sent for histopathological examination.
Advantages of laparoscopic surgery
- Minimal surgical trauma
- Less postoperative pain
- Fast recovery
- Lower risk of infectious complications
- Shorter hospital stay
- Better cosmetic result
- Quick return to everyday life
- A high level of safety when modern surgical standards are followed
Recovery after surgery
Postoperative treatment follows *ERAS* principles.
In most cases, patients start walking just a few hours after surgery and quickly resume eating. After an uncomplicated laparoscopic cholecystectomy, discharge is possible as early as the next day.
A return to normal physical activity usually takes *1--2 weeks*.
Our advantages
- Extensive experience in laparoscopic biliary surgery
- Use of the *Critical View of Safety* principle
- Use of *ICG fluorescent cholangiography* when indicated
- Treatment of both planned and emergency patients
- Modern laparoscopic equipment
- Adherence to EAES, SAGES, Tokyo Guidelines, and WSES recommendations
- Enhanced recovery program (ERAS)
Frequently Asked Questions
Yes. The gallbladder is not a vital organ. After it is removed, bile flows continuously from the liver into the intestine, and most people lead a normal life without significant restrictions.
In the vast majority of cases, yes. However, severe inflammation, massive adhesions, or other difficult situations may require conversion to open surgery.
In the first weeks, a gentle diet is recommended, with a gradual return to your usual diet. Most patients do not need a special diet afterwards.
The gallbladder is removed completely, so stones can no longer form in it. In rare cases, stones may form in the bile ducts.
Not always. Surgery is recommended for polyps larger than *10 mm*, rapidly growing polyps, suspected malignancy, or additional risk factors for gallbladder cancer.