Laparoscopic Cholecystectomy

Modified on 2009/10/14 21:44 by admin
Laparoscopic cholecystectomy is a relatively new operation involving removal of the gallbladder that was first performed in France in 1987 and in the United States in 1988. It is performed using laparoscopic visualization of the gallbladder and surrounding vital structures. After distention of the abdominal cavity with carbon dioxide gas, the laparoscopic imaging and surgical instruments are introduced through multiple (about half-inch) incisions for visualization, manipulation, and dissection. The operation is viewed on a videoscreen with magnification.

The operative steps, which include identification, isolation, and division of the cystic duct and artery, with subsequent removal of the gallbladder from its attachment to the liver, require meticulous surgical technique. Once free, the gallbladder is pulled through one of the small incisions to the exterior, the laparoscope and instruments are removed, and the incisions are closed with sutures and covered with small bandages.

About 90 percent of cholecystectomies are performed laparoscopically. The operation usually requires general anesthesia and is subject to the same risks and complications as open cholecystectomy. However, patients have little pain after the operation, and hospital stays (1-2 days) and convalescence (1-2 weeks) are usually shorter than after open cholecystectomy.

Patients who are usually not candidates for laparoscopic cholecystectomy include those with generalized peritonitis, septic shock from cholangitis, severe acute pancreatitis, end-stage cirrhosis of the liver with portal hypertension, severe coagulopathy unresponsive to treatment, known cancer of the gallbladder, and cholecysto-enteric fistulas. In addition, patients in the third trimester of pregnancy should not usually undergo laparoscopic cholecystectomy, because of risk of damage to the uterus during the procedure.

Laparoscopic cholecystectomy is not without complications. Evidence indicates that the incidence of bile duct injuries is increased compared with the incidence from open cholecystectomy. Damage to blood vessels and the intestines can occur during a poorly executed laparoscopy. Surgical error can lead to serious internal injuries and may endanger the life of the patient.

If you have suffered an injury following a laparoscopic cholecystectomy, it may be important for you to contact an attorney to help you protect your legal rights. Please keep in mind that there may be time limits within which you must commence suit.

See Also

  1. Laparoscopy: Overview
  Name Size