İstanbul Üniversitesi İstanbul Tıp Fakültesi Genel Cerrahi Anabilim Dalı
Gallstones and gallbladder disease can be treated with laparoscopic cholecystectomy. In suitable cases the minimally invasive approach allows a short hospital stay; the treatment decision is made individually for each patient.
Gallbladder diseases include gallstones (cholelithiasis), gallbladder inflammation (cholecystitis), bile-duct stones (choledocholithiasis) and gallbladder polyps. Roughly 10–15% of adults are estimated to have gallstones.
The majority of stones remain silent. When they become symptomatic, however, they can affect quality of life and may lead to potentially life-threatening complications such as cholecystitis, cholangitis and pancreatitis.
Right upper abdominal pain with fever (acute cholecystitis), jaundice and dark urine (cholangitis), and severe abdominal pain with vomiting (pancreatitis) require urgent evaluation.
The treatment approach in gallbladder disease depends on the type of disease, the severity of symptoms and the patient's general condition. The appropriate method is selected individually for each patient following clinical assessment. The information below is for general medical information and does not replace personalised medical advice.
Laparoscopic cholecystectomy is a minimally invasive operation in which the gallbladder is removed through 3–4 small incisions. The procedure takes about 30–60 minutes; the biliary anatomy is carefully exposed and, where needed, assessed with intraoperative cholangiography.
Patients are usually discharged the same or the following day. A normal diet is typically resumed within 1–2 days, office work within 5–7 days, and physical activity within 2–3 weeks. Compared with open surgery, less postoperative pain, a shorter hospital stay and a lower wound-infection risk are reported. Recovery may vary from patient to patient.
When acute cholecystitis develops, antibiotic therapy is started; in suitable cases, early laparoscopic cholecystectomy (within 48–72 hours) is associated with fewer complications and a shorter hospital stay than delayed surgery. The timing of surgery is determined by the patient's clinical condition.
For stones that have dropped into the bile duct (common bile duct), ERCP (Endoscopic Retrograde Cholangiopancreatography) is first used to clear the duct. Laparoscopic cholecystectomy is then performed during the same admission or a few days later.
The triad of jaundice, fever and abdominal pain (Charcot's triad) suggests cholangitis; in this case early ERCP and antibiotic therapy are considered.
Gallbladder polyps are usually found incidentally on ultrasonography. Most small polyps are not true polyps but cholesterol deposits. Surgical indications may include a size of 10 mm or more, rapid growth (>2 mm in 6 months), age over 50 and coexisting gallstones; the decision is based on clinical assessment.
True adenomatous polyps may carry a risk of malignant transformation. Follow-up ultrasonography every 6 months is generally recommended.
Prof. Dr. Hakan Yanar is a General Surgery Specialist practising at Liv Hospital Ulus. Emergency and elective cholecystectomy, cases combined with ERCP and anatomical variations of the biliary tract are assessed; the treatment plan is determined individually for each patient. Consultations are conducted in Turkish and English; interpreter support for other languages is available through the hospital.
You can discuss your gallbladder symptoms with Prof. Dr. Hakan Yanar.
