47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct

Name of the Procedure:

Laparoscopy, surgical; cholecystectomy with exploration of common duct

Common name(s): Laparoscopic Cholecystectomy with Common Bile Duct Exploration
Technical/medical terms: Laparoscopic Gallbladder Removal with Common Duct Exploration

Summary

This minimally invasive surgical procedure involves the removal of the gallbladder and the exploration of the common bile duct using a laparoscope. The laparoscope is a small tube with a camera and light at the end, allowing the surgeon to view the organs inside the abdomen and perform the surgery through small incisions.

Purpose

The procedure addresses gallbladder disease, such as gallstones, inflammation, or infection, and ensures there is no obstruction or stones in the common bile duct. The goal is to relieve symptoms, prevent complications, and improve the patient's quality of life by removing the diseased gallbladder and ensuring bile can flow properly.

Indications

• Gallstones causing pain, infection, or inflammation (cholecystitis)
• Blockage or stones in the common bile duct
• Biliary dyskinesia (improper functioning of the gallbladder)
• Pancreatitis caused by gallstones

Preparation

• Patient may need to fast for several hours prior to the surgery.
• Instructions will be given to stop certain medications that may affect blood clotting.
• Pre-operative tests may include blood work, imaging tests like an ultrasound, and sometimes an MRI or CT scan.
• Discussion with the surgeon and anesthesiologist to review medical history and anesthesia plan.

Procedure Description

1. The patient is given general anesthesia.
2. Several small incisions are made in the abdomen.
3. A laparoscope is inserted through one of the incisions, and additional surgical instruments are inserted through others.
4. The surgeon removes the gallbladder and examines the common bile duct for any stones or obstructions.
5. If stones are found in the common bile duct, special tools are used to remove them.
6. The incisions are closed with sutures or surgical staples.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Common risks: Infection, bleeding, injury to surrounding organs, anesthesia-related complications.
• Rare risks: Bile leak, blood clots, heart or lung problems, retained stones in the bile duct.

Benefits

• Relief from gallbladder-related pain and discomfort.
• Prevention of complications such as infections or pancreatitis.
• Improved digestion and overall quality of life.
• Faster recovery compared to an open surgery.

Recovery

• Patients can often go home the same day or after a short hospital stay.
• Pain and discomfort are typically managed with medications.
• Most patients can return to normal activities within 1 to 2 weeks.
• Follow-up appointments are necessary to monitor recovery.

Alternatives

• Non-surgical options include medications to dissolve stones, though these are less effective.
• Endoscopic Retrograde Cholangiopancreatography (ERCP) for bile duct stones.
• Open cholecystectomy, which involves a larger incision and longer recovery time.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. After the procedure, some pain and discomfort at the incision sites can be expected, typically managed with pain medication. Mild shoulder pain may also be felt due to the gas used to inflate the abdomen during surgery. Most patients will notice significant symptom relief once they recover.