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How is minimally invasive surgery for cholecystitis performed?

Nov 05, 2025 Source: Cainiu Health
Dr. Gao Jun
Introduction
Minimally invasive surgery for cholecystitis is primarily performed through the following steps: establishing a pneumoperitoneum, inserting surgical instruments, exploring the gallbladder, dissecting and removing the gallbladder, and hemostasis with suturing. This approach involves minimal surgical trauma and allows for rapid recovery, but must be conducted by a professional medical team. If persistent severe pain in the right upper abdomen, fever, chills, or similar symptoms occur, immediate medical attention is recommended. After administration of general anesthesia, the surgeon makes small incisions in the patient's abdomen.

Minimally invasive surgery for cholecystitis is primarily performed through the following steps: establishing a pneumoperitoneum, inserting instruments, exploring the gallbladder, dissecting and removing the gallbladder, and hemostasis with suturing. This procedure involves minimal surgical trauma and allows for rapid recovery, but must be conducted by a professional medical team. If persistent severe pain in the upper right abdomen, fever, chills, or similar symptoms occur, immediate medical attention is recommended.

1. Establishing Pneumoperitoneum: After general anesthesia, the surgeon makes small incisions in the abdomen and introduces carbon dioxide gas into the abdominal cavity to create a pneumoperitoneum. This expands the abdominal cavity, providing sufficient space for surgical manipulation and enabling clear visualization of internal structures.

2. Inserting Instruments: Through small incisions at different locations on the abdomen, a laparoscope (equipped with a camera) and specialized surgical instruments are inserted. The laparoscope transmits real-time images of the abdominal cavity to a monitor, allowing the surgeon to view and guide the procedure.

3. Exploring the Gallbladder: Using the laparoscope, the surgeon assesses the severity of gallbladder inflammation, evaluates adhesions between the gallbladder and surrounding tissues, and identifies the positions of the cystic artery and bile ducts to avoid damaging critical blood vessels and organs during surgery.

4. Dissecting and Removing the Gallbladder: Surgical instruments are used to separate the gallbladder from surrounding tissues. The cystic artery and cystic duct are clipped and cut, after which the gallbladder is detached from the liver bed and removed from the body through one of the incisions.

5. Hemostasis and Suturing: After removal of the gallbladder, the surgeon carefully checks the surgical area for any bleeding. Once hemostasis is confirmed and no abnormalities are found, the gas within the abdominal cavity is evacuated, and the small abdominal incisions are sutured, completing the procedure.

After surgery, patients should gradually resume their diet as directed by their physician—starting with liquid foods before transitioning back to a normal diet—and avoid greasy foods. Early postoperative ambulation is encouraged to promote gastrointestinal recovery. Wound sites should be kept clean to prevent infection.

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Gallstone pain typically occurs due to obstruction of the cystic duct by stones, strong gallbladder contractions, irritation of the gallbladder mucosa by stones, secondary cholecystitis, or blockage of the common bile duct. When stones become lodged in the cystic duct as they move with bile flow, they prevent bile drainage, leading to increased pressure within the gallbladder. This causes stretching and stimulation of the gallbladder wall, resulting in intermittent or persistent pain, which is usually localized in the right upper abdomen.
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Is surgery required for cholecystitis complicated with gallstones?
In general, whether surgery is needed for cholecystitis accompanied by gallstones should be determined based on a comprehensive assessment of disease severity, symptom presentation, characteristics of the stones, and the patient's overall health condition. After detection of coexisting gallstones, regular medical follow-ups are necessary to closely monitor disease progression. It is advisable to maintain a low-fat diet daily, avoid alcohol consumption and excessive fatigue, to reduce discomfort caused by gallbladder contractions.
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Should you fast during a gallbladder attack?
In general, whether fasting is required during a gallbladder attack depends on the severity of the condition. When symptoms are mild, strict fasting is not necessary; patients may consume small amounts of light liquid foods. However, temporary fasting is needed when symptoms are severe. In daily care, patients with cholecystitis should maintain regular eating habits, avoid overeating, steer clear of high-fat and spicy foods, and minimize triggers that could provoke gallbladder attacks.
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Why does cholecystitis cause stomach pain?
In general, the main reasons why cholecystitis causes stomach pain include neural reflex effects, spread of inflammatory stimulation, abnormal bile secretion, gastrointestinal dysfunction, and confusion in pain localization. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, one should maintain regular eating habits, avoid overeating or prolonged fasting, and reduce intake of high-fat and high-cholesterol foods.
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Which is more severe: acute cholecystitis or chronic cholecystitis?
In general, the severity of acute cholecystitis and chronic cholecystitis cannot be directly compared, as it depends on the specific progression of the disease and the individual's health condition. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, overeating and binge eating should be avoided, and intake of high-fat, high-cholesterol foods should be reduced. Seek medical attention promptly if abdominal pain worsens or fever develops.
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Do all patients with gallstones have cholecystitis?
Not all patients with gallstones have cholecystitis. Gallstones are solid crystals formed due to abnormal components in bile, while cholecystitis is an inflammatory disease of the gallbladder. Some patients with gallstones may have no signs of gallbladder inflammation for a long time; however, gallstones are a major contributing factor in developing cholecystitis. If symptoms such as right upper abdominal pain or fever occur, prompt medical attention is recommended.
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What are the most severe consequences of gallstones?
There is no such thing as "how severe gallstones can possibly get." Gallstones may lead to asymptomatic carriage, trigger biliary colic, cause cholecystitis, result in bile duct obstruction, or increase the risk of gallbladder cancer. Timely intervention should be based on specific clinical manifestations. If sudden severe abdominal pain, fever, jaundice, or similar symptoms occur, immediate medical attention is recommended.
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How to treat gallstones caused by cholecystitis
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