Where is the incision made for gallstone surgery?

Sep 22, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

In general, the surgical incision site for gallstones is determined based on the surgical approach and the patient's specific condition. Common incision sites include below the right upper abdominal rib margin, mid-upper abdomen, laparoscopic port sites in the right upper abdomen, the umbilicus, and below the xiphoid process. Ultimately, the choice of incision site must be decided by the physician, taking into account factors such as the size and location of the stones, the degree of gallbladder inflammation, and the selected surgical method.

Generally, the incision site for gallstone surgery depends on the surgical approach and the patient's specific condition. Common incision sites include below the right costal margin, mid-upper abdomen, laparoscopic ports in the right upper quadrant, the umbilicus, and below the xiphoid process. Detailed explanations are as follows:

1. Below the Right Costal Margin

This area is close to the location of the gallbladder, which lies beneath the liver in the right upper abdomen. An incision here provides direct access to the gallbladder, facilitating surgical manipulation. Traditional open cholecystectomy often uses this site, especially suitable for patients with large stones, severe gallbladder inflammation, or other complicated conditions. The clear surgical field allows effective treatment of the lesion, making this a common choice for open procedures.

2. Mid-Upper Abdomen (Midline)

When gallstones lead to common bile duct stones or when anatomical variations are present, a midline incision in the upper abdomen may be chosen. This approach provides better exposure of the bile duct, allowing the surgeon to examine the duct and remove stones effectively. It also enables simultaneous gallbladder removal, making it ideal for patients requiring treatment of both gallbladder and bile duct issues.

3. Laparoscopic Port in the Right Upper Quadrant

Laparoscopic surgery requires several small abdominal incisions, one of the key ports being placed in the right upper quadrant. Aligned with the gallbladder’s position, this port allows insertion of surgical instruments for dissection and removal of the gallbladder, working in coordination with other ports to complete the procedure. This approach minimizes surgical trauma and promotes faster recovery, making it a standard component of laparoscopic cholecystectomy.

4. Umbilicus

The umbilicus is another common site for a laparoscopic port. The natural skin folds around the navel can conceal the incision, resulting in minimal visible scarring and improved cosmetic outcomes. Additionally, inserting the laparoscope through the umbilicus provides a clear view of the abdominal cavity, guiding instrument placement at other ports during gallbladder removal. This site is particularly favored by patients concerned about postoperative appearance.

5. Subxiphoid Area (Below the Xiphoid Process)

Located near the neck of the gallbladder, a small subxiphoid incision is sometimes used in laparoscopic surgery. It aids in retracting the gallbladder to improve surgical visibility or facilitates handling stones lodged in the gallbladder neck. This port enhances precision in manipulating critical areas of the gallbladder, improving surgical efficiency and safety, and is therefore used in selected laparoscopic cases.

In addition, the final decision on incision placement is made by the surgeon based on factors such as stone size and location, severity of gallbladder inflammation, and the chosen surgical method. Patients should have thorough discussions with their surgeons before surgery to understand the exact incision sites and postoperative care instructions, helping them prepare adequately for both the procedure and recovery.

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Do you still get cholecystitis after gallbladder removal?

In general, after cholecystectomy, one will no longer develop cholecystitis since the primary organ where inflammation occurs has been removed. However, abdominal discomfort similar to cholecystitis may occur after surgery and should be differentiated from the original condition. In daily life, individuals who have undergone cholecystectomy should maintain a light diet, avoid consuming large amounts of greasy food at once, and thereby reduce the burden on the bile ducts in secreting bile.

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Which department should I visit for gallbladder swelling?

In general, patients with gallbladder lesions are advised to first seek care from departments specializing in hepatobiliary diseases, such as hepatobiliary surgery, gastroenterology, general surgery, emergency medicine, and ultrasound. The choice of department should be based on symptoms, severity of the condition, and the specific departmental structure of the medical institution. Asymptomatic individuals may initially be followed up in gastroenterology or general surgery.

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Can gallstones be passed out?

In general, whether gallstones can be passed depends on the size and location of the stones, as well as the patient's specific symptoms and complications. If discomfort occurs—such as abdominal pain, jaundice, or fever—it is recommended to seek medical attention promptly to avoid risks associated with self-treatment. Regardless of whether the stones can be expelled, regular monitoring via ultrasound is necessary to track changes in the stones. A low-fat diet should be maintained in daily life.

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Which department should I visit for gallbladder polyps?

In general, patients with gallbladder polyps can choose the appropriate department based on their individual conditions. Common departments include hepatobiliary surgery, gastroenterology, general surgery, emergency medicine, and physical examination centers. Additionally, it is recommended to research the hospital's departmental structure and doctors' specialties in advance—through the hospital's official website or by phone consultation—to select the most suitable department and physician before visiting.