47563 Laparoscopy, surgical; cholecystectomy with cholangiography

Name of the Procedure:

Laparoscopy, surgical; cholecystectomy with cholangiography
Common name(s): Laparoscopic gallbladder removal with bile duct imaging

Summary

Laparoscopic cholecystectomy with cholangiography is a minimally invasive surgery to remove the gallbladder while also imaging the bile ducts to check for stones or other issues. Tiny incisions are made in the abdomen to insert a camera and surgical tools.

Purpose

This procedure addresses the following conditions:

• Gallstones causing pain or infection (cholecystitis)
• Gallbladder polyps
• Biliary dyskinesia Its goals are to relieve symptoms, prevent complications, and ensure that bile ducts are free of obstructions.

Indications

• Recurrent gallbladder pain
• Inflammatory conditions like cholecystitis
• Jaundice or pancreatitis due to gallstones
• Abnormal gallbladder function tests

Preparation

• Patients may need to fast for 8 hours prior.
• Certain medications might need to be adjusted.
• Pre-operative blood tests, ultrasound, and possibly MRI or CT scans are done to plan the surgery.

Procedure Description

1. General anesthesia is administered.
2. Small incisions are made in the abdomen.
3. A laparoscope (a tiny camera) and surgical instruments are inserted.
4. The gallbladder is detached and removed.
5. A cholangiogram (X-ray of the bile ducts) is performed to look for stones or obstructions.
6. Incisions are closed with sutures or staples. Tools: Laparoscope, trocars, surgical instruments, contrast dye for cholangiography.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital's surgical suite or an outpatient surgical center.

Personnel

• General Surgeon
• Anesthesiologist
• Surgical Nurses
• Radiologist (for interpreting cholangiography)

Risks and Complications

• Common risks: infection, bleeding, and adverse reactions to anesthesia.
• Rare but serious complications: injury to nearby organs (bile ducts, intestines), bile leak, deep vein thrombosis.
• Management: Antibiotics for infection, revision surgery for severe complications.

Benefits

• Relief from gallbladder-related pain and symptoms.
• Prevention of future complications like gallbladder rupture or pancreatitis.
• Quick recovery and minimal scarring compared to open surgery.

Recovery

• Post-operative monitoring for a few hours.
• Pain management with prescribed medications.
• Gradual return to normal activities in about 1 to 2 weeks.
• Follow-up appointment within a week or two to check healing progress.

Alternatives

• Open cholecystectomy (more invasive, longer recovery).
• Non-surgical options like medication to dissolve gallstones (less effective, longer duration).
• Endoscopic procedures like ERCP to remove bile duct stones.

Patient Experience

• During: The patient will be under general anesthesia and won't feel anything.
• After: Mild to moderate discomfort at incision sites, managed with pain medication.
• Pain management: Over-the-counter analgesics or prescribed painkillers.
• Comfort measures: Cold packs for incision pain, and gradual introduction of a normal diet.