Laparoscopic cholecystectomy

Here is what actually happens during your operation. 3–4 small cuts are made in your abdomen — each one roughly the size of your fingernail — and a tiny camera and fine instruments are passed through them to gently remove your gallbladder. You will be completely asleep under a general anaesthetic the whole time, so you will not feel or remember anything. The whole operation usually takes between 45 and 90 minutes. This keyhole approach is used when gallstones (hard deposits that form inside the gallbladder) are causing you pain, infection called cholecystitis (where the gallbladder becomes inflamed), or have triggered pancreatitis (inflammation of the pancreas — the digestive organ that sits just behind your stomach). For almost everyone, going home the same day or the following morning is the plan.

You may be recommended this operation for any of the following reasons:

• Gallstones that are giving you pain — this pain is called biliary colic, and it feels like cramping or gripping discomfort in your upper right abdomen, often coming on after a fatty meal
• Acute cholecystitis — your gallbladder has become suddenly inflamed and infected, causing severe pain and sometimes fever; this needs prompt treatment
• Gallstone pancreatitis — a stone has slipped out of the gallbladder and into the bile duct (the tube that carries digestive fluid from the liver), irritating the pancreas as it goes; surgery is usually planned during your current hospital stay or within the next two weeks
• Biliary dyskinesia — your gallbladder is not working properly, even without visible stones; this is diagnosed with a HIDA scan, a type of nuclear medicine imaging test where a small amount of radioactive tracer is injected and pictures are taken to see how well the gallbladder empties
• Gallbladder polyps (small growths on the inner wall) larger than 10 mm, or smaller ones that your doctor has noticed growing during monitoring
• Porcelain gallbladder — where calcium has built up in the gallbladder wall — in selected situations

Choosing the keyhole approach has real advantages for you:

• Just 3–4 tiny cuts — little scarring, and a fraction of the wound size of the old open operation
• You will most likely go home the same day or the following morning — this is not a long stay in hospital
• In published series, less post-operative pain than with a traditional large-incision approach
• Most people are back to desk work or light tasks within 1–2 weeks
• The great majority of operations are completed through the keyhole without needing to switch to open surgery
• This is a permanent fix — once your gallbladder is removed, you simply cannot form gallbladder stones again, because there is no gallbladder left to form them in

It is completely reasonable to want to understand the risks before you agree to anything. All surgery carries some risk, but for this particular operation the risks are small. Each of these will be discussed with you in detail before your surgery, so please bring any questions you have to that conversation.

• Bile duct injury — damage to the bile duct (the thin tube that carries digestive fluid from your liver down to your small intestine) is the most serious possible complication. In published series it is rare — around 1 in 200 to 1 in 500 operations. A strict safety approach called the "critical view of safety" is used every single time to prevent this
• Bile leak — occasionally a tiny amount of bile escapes from the clip that seals the duct. This happens in roughly 0.5–1% of cases and is almost always managed with a drain or short procedure, without needing a return to theatre
• Wound infection — affects 1–3 in every 100 patients; straightforward to treat with a short course of antibiotics
• Bleeding after surgery — occurs in fewer than 1 in 100 cases
• A stone left in the common bile duct — the main duct that drains bile into your gut. This is found in 2–5% of patients; if this happens to you, the stone can be removed through a procedure called ERCP (a flexible camera passed through your mouth while you are sedated — no additional cuts required)
• Conversion to open surgery — in fewer than 1 in 20 planned keyhole operations, the surgeon needs to make a larger incision to finish the operation safely. This is not a complication or a failure — it is always a calm, deliberate safety decision made in your best interests

If you take blood thinners, diabetes medication, GLP-1 weight-loss injectables, or iron supplements, please flag this when you book — these need specific adjustments before the procedure. Full details are in the guide above.

• Before surgery you will have blood tests to check how your liver is working, along with your blood count and clotting ability — and an ultrasound of your abdomen to confirm what is going on with your gallbladder
• You will have a proper consent conversation before the operation, with a step-by-step walk-through of the procedure, an honest explanation of the risks (including the small possibility of needing to switch to open surgery), and all the time you need to ask questions — there are no silly questions
• When the anaesthetic is started, you will be given a dose of antibiotics through a drip to lower the risk of infection after surgery

Here is a step-by-step picture of what happens so there are no surprises:

• You will be admitted to Warringal Private Hospital or Epworth Eastern on the morning of your operation and given a general anaesthetic — you will be completely asleep and positioned lying on your back
• Three to four small ports (thin hollow tubes, roughly the width of a pen) are placed through tiny skin cuts; your abdomen is then gently inflated with harmless carbon dioxide gas, which creates a safe working space inside so the instruments can move freely
• A tiny camera is used to find your gallbladder; it is then carefully separated from the underside of your liver, following a strict safety protocol every time called the "critical view of safety" — this means each structure is identified and confirmed before anything is cut
• The cystic duct (the small tube connecting your gallbladder to the bile system) and cystic artery (the blood vessel that feeds the gallbladder) are clipped with tiny metal clips and then divided — a quick, precise step
• The gallbladder is gently pulled out through the small cut near your belly button and sent to the laboratory for routine examination (called histology) — this is standard and almost always comes back with nothing unexpected
• You wake up in the recovery area. Once you are comfortable, pain is under control, and you are fully awake, you are moved to the day-stay unit. Most people go home the same afternoon or the following morning

For most people, recovery is straightforward. Here is what to expect, week by week:

• Day of surgery and day 1: You may notice some mild aching in your upper right abdomen, and perhaps a dull, achy feeling in your right shoulder or neck — this sounds strange, but it is entirely from the gas used during surgery, not a sign of anything wrong. It settles on its own within a day or two
• Days 1–3: You can eat and drink normally and move around the house comfortably. For most people, regular paracetamol (Panadol) is all they need to stay comfortable
• Days 2–3: If you stayed overnight, you will be ready to go home once you are eating well, your pain is under control with tablets, and the nursing team is satisfied with how you are doing
• 1 week: Most people feel well enough to return to desk work or work from home and go about their everyday routine. Avoid heavy lifting and strenuous activity for 2–3 weeks to give your small wound sites time to heal properly
• Driving: You can get back behind the wheel once you are off strong pain medication and can turn quickly and do an emergency stop without hesitation — for most people that is around 5–7 days after surgery
• Loose stools after surgery: About 1 in 10 people notice softer or more frequent bowel movements for a few weeks or months after gallbladder removal — this is called post-cholecystectomy diarrhoea. It happens because, without the gallbladder storing bile, your liver releases it in a steady trickle rather than in bursts. It is normal, it is not dangerous, and it almost always settles on its own within 3–6 months. If it is bothering you, please raise it at your follow-up or with your GP
• Your diet long-term: You do not need to follow any special diet once your gallbladder is removed. Your liver continues making bile and simply releases it directly into your small intestine — you can eat normally, including fatty foods
• A post-operative review is routinely arranged 2–6 weeks after your surgery to check in on how you are going — this review is provided at no charge
• For day-by-day guidance on wound care, diet, shoulder-tip discomfort from the gas, and graded return to activity, see the Post-cholecystectomy aftercare guide on the Resources page.

Post-operative concerns: Please call our rooms on (03) 9816 3951 and leave a message — this will be sent directly as a text to Mr Nguyen. Alternatively, you may text the office mobile on 0499 090 126. We aim to respond promptly during business hours.

Emergencies: For any life-threatening emergency, call 000 immediately or go to your nearest emergency department. Do not wait for a call back from our rooms. For the Austin Hospital Emergency Department: (03) 9496 5000.