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Laparoscopy, surgical; cholecystectomy

CPT4 code

Name of the Procedure:

Laparoscopy, surgical; cholecystectomy
Common name(s): Laparoscopic Cholecystectomy, Keyhole Gallbladder Removal Surgery

Summary

Laparoscopic cholecystectomy is a minimally invasive surgical technique to remove the gallbladder. This procedure uses small incisions and a camera to guide the surgeon, allowing for a quicker recovery compared to traditional open surgery.

Purpose

This procedure is primarily performed to treat gallstones, gallbladder inflammation (cholecystitis), gallbladder polyps, and biliary dyskinesia. The goal is to alleviate pain, prevent complications like infection or pancreatitis, and improve the patient's quality of life.

Indications

  • Symptomatic gallstones
  • Acute or chronic cholecystitis
  • Gallbladder polyps larger than 1 cm
  • Biliary colic
  • Gallbladder dysfunction
  • Previous pancreatitis linked to gallstones

Preparation

  • Patients are usually required to fast for at least 8 hours before surgery.
  • Medication adjustments may be necessary as advised by the doctor.
  • Preoperative tests might include blood work, ultrasound, or other imaging studies to assess the gallbladder and surrounding tissues.

Procedure Description

  1. Patient is placed under general anesthesia.
  2. A small incision is made near the navel, and a laparoscope (a thin tube with a camera) is inserted.
  3. Additional small incisions are made to insert surgical instruments.
  4. The gallbladder is separated from the liver and other structures.
  5. The gallbladder is removed through one of the small incisions.
  6. The incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This surgery is usually performed in a hospital or an outpatient surgical center.

Personnel

  • General Surgeon specializing in laparoscopic procedures
  • Anesthesiologist
  • Surgical Nurses
  • Operating Room Technicians

Risks and Complications

  • Common: Bleeding, infection, injury to surrounding organs like bile ducts or intestines.
  • Rare: Blood clots, adverse reactions to anesthesia, bile leakage, persistent pain.

Benefits

  • Relief from gallbladder-related pain and symptoms.
  • Lower risk of future gallbladder problems.
  • Shorter recovery period and less postoperative pain compared to open surgery.
  • Most patients are able to return home the same day or the day after.

Recovery

  • Patients are usually advised to rest and avoid strenuous activities for a couple of weeks.
  • A light diet may be recommended initially, progressing to a normal diet as tolerated.
  • Follow-up appointments are necessary to monitor healing and manage any complications.

Alternatives

  • Medication to dissolve gallstones, though this is less effective and slower.
  • Endoscopic retrograde cholangiopancreatography (ERCP) for certain bile duct stones.
  • Open cholecystectomy: traditional surgery with a larger incision, longer recovery time.
  • Non-surgical observation if symptoms are mild or infrequent.

Patient Experience

Patients are under anesthesia during the procedure and will not feel anything. Postoperatively, some pain and discomfort at the incision sites are expected and managed with pain medication. Most patients experience significant symptom relief once healing is complete.

Medical Policies and Guidelines for Laparoscopy, surgical; cholecystectomy

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