Laparoscopic Cholecystectomy

The gallbladder is a small pear-shaped organ that lies beneath your liver on the upper right side of your abdomen. It stores bile, a digestive fluid produced by your liver. The gallbladder releases bile into the small intestine to digest fat at meal times. If the gallbladder is removed, bile will continue to be produced by the liver and flow directly into the small intestine.

Gallstones are small stone-like substances that develop when the amount of bile and other fluids stored in the gallbladder become unbalanced and harden.

Asians are more prone to develop gallstones compared to patients in the west.

Additionally, many with gallstone disease have no obvious risk factors.

Some gallstones cause pain, bloating, infection and blockage of the flow of bile. If there is severe pain, infection or other complications, your doctor will likely recommend that you have your gallbladder removed in a common operation called cholecystectomy since it is a non-essential organ. If gallstones are found incidentally with no symptoms, they can be observed and surgery is generally not recommended.

The standard form of treatment is minimally invasive surgery known as laparoscopic cholecystectomy, in which our surgeon makes four small incisions in your abdomen to remove the gallbladder. However, certain scenarios or conditions may make open surgery (incision about 8cm) necessary or a safer and better choice.

Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed before or after laparoscopic cholecystectomy if stones are found in the bile duct.

Compared to open surgery, laparoscopic cholecystectomy offers these advantages:

The overall risk of laparoscopic cholecystectomy is very low. Although uncommon, the more serious possible complications include:

You will be admitted the day before or on the morning of your surgery.

After surgery, you will usually stay one night. You may be required to stay a few more nights if you have open surgery. Younger, fitter patients may go home in the evening of the same day.

General anaesthesia will be given regardless of the type of surgery. In cholecystectomy, a laparoscopic camera is inserted through one of the four incisions (near the belly button) to provide a close-up view of your organs. Surgery to remove the gallbladder is performed through three smaller incisions (0.5cm) and removal is through incision near the belly button.

Laparoscopic surgery is safe and effective. If any difficulties occur during a laparoscopic surgery, the surgeon will switch to open surgery.

This may happen if there is unusual anatomy, severe inflammation or infection. This is done with the patient’s safety and best interest as the foremost priority.

After you wake up from anaesthesia, you will be observed for a few hours. You will be allowed to drink fluids or have a light meal. On the day following surgery, you should be able to resume your usual diet and move around.

Depending how you feel, you may be discharged the day after surgery. Day surgery patients may be discharged on the same day. Rest at home for 1 – 2 weeks and avoid fatty food immediately and lifting heavy loads after surgery. You will be given a follow-up appointment with your surgeon in about 1-2 weeks.

Recovery after laparoscopic surgery is faster and less painful as compared to open surgery. Oral pain medication will be prescribed and no removal of stitches is required.

It is also the national referral centre for Haematology, Renal Medicine, Nuclear Medicine, Orthopedic Surgery, Pathology and Plastic Surgery (Burns).

As an academic healthcare institution, SGH provides postgraduate training and plays a major role in undergraduate training and clinical teaching for medical professionals locally and in the region. It is also committed to innovative translational and clinical research to provide the best possible care for patients.