Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder. In almost all cases, it's performed laparoscopically. It's a relatively technically simple procedure.

Indications

Cholecystectomy is the definitive treatment for gallstone disease, especially cholecystitis, biliary colic which isn't controlled conservatively, choledocholithiasis, and cholangitis caused by choledocholithiasis.

Timing

There are two approaches to the timing of cholecystectomy in case of cholecystitis, early surgery and delayed surgery. This is to avoid performing surgery on an inflamed organ if possible.

In most cases, we opt for delayed surgery. In that case, the patient is treated conservatively, and if they respond to this the surgery is delayed for 6 – 8 weeks, after the acute inflammation has resolved, which reduces the risk for perioperative complications.

If the patient does not respond to initial conservative therapy, or they have indications for acute surgery like pericholecystic fluid or evidence of gangrene or perforation on imaging, surgery will be performed acutely.