Laparoscopic Cholecystectomy

Background Information: Cholecystectomy is the surgical removal of the gallbladder. This procedure may be performed via the open procedure or minimally invasive (laparoscopic or robotic). 

Indications: 

• Acute Cholecystitis
• Symptomatic cholelithiasis (biliary colic)
• Choledocholithiasis
• Gallbladder pancreatitis
• Gallstone ileus
• Mirizzi Syndrome
• Gallbladder cancer
• Gallbladder polyps >1cm
• Porcelain gallbladder 

Key Anatomy:

• Gallbladder

• ~Fundus
• ~Body
• ~Neck
• ~Infundibulum

• Triangle of Calot (hepatocystic triangle)
• Calot's (cystic) lymph node
• Cystic artery
• Cystic duct
• Common bile duct
• Common hepatic duct
• Rouviere's sulcus

Surgical Risks:

General surgical risks:

• Bleeding
• Infection

Risks specific to Cholecystectomy 

• Common bile duct injury (0.22% incidence for laparoscopic repairⁱ)
• Bile leak from the transected cystic duct (0.5% incidence for laparoscopic repairⁱ)
• Enterotomy

• ~0.22% incidence for laparoscopic surgery²

• Postoperative ileus

• ~Risk lower for minimally invasive procedures vs. open

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