What Is an Endoscopic Cholecystectomy?

Endoscopic cholecystectomy refers to removal of a gallbladder using tiny instruments, a camera, and light source. It involves a small incision near the belly button to allow insertion of surgical tools. A gas inflates the abdomen in endoscopic cholecystectomy to create space needed to excise a diseased or infected gallbladder. This form of surgery is generally preferred over open gallbladder surgery because of shorter recovery times and less pain.

Other advantages to endoscopic cholecystectomy include a shorter hospital stay, which reduces cost of the procedure. Patients typically return to work sooner after endoscopic surgery and suffer less pain and scarring. Gallbladder removal represents a common surgical procedure done via a laparoscope, which is similar to a miniature telescope used to guide surgical instruments.

The gallbladder stores bile produced in the liver and releases it into the small intestine to aid digestion of fats. Bile ducts, small tubes that connect the gallbladder to the intestines, carry bile when the gallbladder contracts. If these ducts become blocked by gallstones, complications might create a need for endoscopic cholecystectomy.

Gallstones develop when cholesterol in bile solidifies and hardens. When these tiny stones remain in the gallbladder, the only symptom might be biliary colic, or episodes of pain in the upper right side of the abdomen. Problems might occur when these stones migrate into the bile duct, causing a blockage.

Acute cholecystitis defines one complication when gallstones move into bile ducts. It usually causes severe pain, accompanied by fever and vomiting. If left untreated, cholecystitis might cause jaundice, marked by yellowing of the skin and eyes. It might also lead to cholangitis, an infection in the bile duct that could spread to the liver.

More serious conditions might also develop, sparking the need for emergency endoscopic cholecystectomy. Gangrene might develop, which could destroy the gallbladder and release toxins to the abdominal cavity. Pancreatitis occurs when pancreatic ducts become blocked by gallstones, with symptoms of pain commonly appearing after eating fatty foods. Bile might also eat through the walls of the gallbladder, allowing infection to spread.

Before performing endoscopic cholecystectomy, doctors typically assess common symptoms of gallstones. Most patients report pain that might radiate to the upper or lower back and between the shoulder blades. Indigestion and excessive gas are other common signs of gallbladder disorders. Some patients experience trouble breathing, an increased heart rate, and confusion during a gallbladder attack.

Serious complications of endoscopic cholecystectomy are considered rare, but could occur. Bile ducts or internal organs might become damaged during the procedure, leading to bleeding or infection. Anesthesia used during the surgery might also cause adverse effects in some patients.

After endoscopic cholecystectomy, patients usually resume normal activities in a week or so. They commonly suffer from nausea, vomiting, or diarrhea for a few days after surgery. Diarrhea might be controlled by eating a diet high in fiber to create bulk in the intestinal tract. Any sign of infection, swelling, or fever after surgery should be reported to a doctor.