Gallbladder Surgery (Cholecystectomy): Indications, Approaches, Recovery

GB surgery = cholecystectomy (gallbladder removal). Most commonly laparoscopic (4 ports); open if contraindicated.

Indications

• Symptomatic cholelithiasis (biliary colic).
• Acute/chronic cholecystitis.
• Choledocholithiasis (with CBD exploration or ERCP).
• Gallstone pancreatitis.
• Porcelain gallbladder (cancer risk).
• Gallbladder polyps >1 cm.
• Biliary dyskinesia (low EF on HIDA).

Laparoscopic vs. Open

Aspect	Laparoscopic	Open
Incision	4 small (0.5-1 cm)	10-15 cm RUQ/Kocher
Pain	Less	More
Stay	Outpatient / 1 night	3-5 days
Recovery	1-2 weeks	4-6 weeks
Conversion rate	2-5% (inflammation, adhesions, anatomy)	N/A

Postoperative Care

• Advance diet as tolerated (low-fat initially).
• Pain control (NSAIDs ± opioids).
• Ambulate early; avoid heavy lifting 2-4 weeks.
• Follow-up 1-2 weeks.

Long-Term

Most asymptomatic. Postcholecystectomy syndrome (10-15%): diarrhea, bloating, pain – often bile acid malabsorption (treat with cholestyramine). No dietary restrictions long-term.