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Gall Bladder Surgery

Important Disclaimer: Gallbladder removal (cholecystectomy) is one of the most common operations worldwide (>700,000/year in USA alone). It is the definitive treatment for gallstones causing symptoms (biliary colic, acute cholecystitis, pancreatitis, choledocholithiasis) or complications. Asymptomatic gallstones usually do NOT need surgery. This is general information — consult a surgeon. Sources: SAGES 2024 guidelines, recent RCTs/meta-analyses.

Indications for Surgery

  • Symptomatic gallstones (biliary colic)
  • Acute cholecystitis (inflamed gallbladder)
  • Gallstone pancreatitis
  • Choledocholithiasis (stones in bile duct — often ERCP first)
  • Gallbladder polyps >1 cm or porcelain gallbladder (cancer risk)

Step-by-Step (Laparoscopic)

  • General anesthesia
  • 4 ports (one 10–12 mm umbilical, three 5 mm)
  • CO₂ insufflation
  • Critical view of safety (CVS) obtained — mandatory to prevent bile duct injury
  • Cystic duct & artery clipped (polymer clips most common) & divided
  • Gallbladder dissected from liver bed (often with energy device — Harmonic/LigaSure)
  • Removed in bag via umbilicus
  • Fascia closed at 10–12 mm port; skin glue/Steri-Strips