Gallbladder Surgery

Where are the surgical cuts in laparoscopic gallbladder surgery and what are are the long term cosmetic results?

2 weeks after surgery

6 months after surgery (different patient)

What about open gallbladder surgery?

Open gallbladder surgery through
a midline incision

Open surgery through a right upper
quadrant incision

Postoperative adhesions following open surgery (patient in previous picture): bowel adhesions associated with chronic abdominal pain and recurrent episodes of bowel obstruction

Note: while the laparoscopic procedures were performed in my practice the open surgery was performed elsewhere.

Gallbladder Surgery Audit 2002-2005

• Median age 52(15-92yo)
• male : female ratio 1:2
• Acute : elective admissions 1.5:1
• Open cholecystectomy 1 patient
• Confersion - 1st 25 cases 3 patients
• Conversion - after 1st 25 cases 0.77%
• Operative cholangiogram attempted 86.7%
• Successful cholangiogram 98.5%
• Unsuspected choledocholithiasis 4.7%
• Successful trancystic bile duct exploration 3.2%
• Common Bile duct stenting 2.6%
• Postoperative ERCP 1.9%