The gallbladder is a small sac that holds bile, a digestive juice produced by the liver that is used in the breakdown of dietary fats. The gallbladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gallbladder to squeeze its bile concentrate into the small intestine.

Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually in a mixture that forms in the gallbladder. They are a common disorder of the digestive system, affecting around 15 per cent of people aged 50 years and over.

In most cases, gallstones don’t cause any problems. However, you might need prompt treatment if stones block ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).

Your surgeon may need to remove your gallbladder (called a cholecystectomy) if gallstones (or other types of gallbladder disease) are causing problems. There are two different techniques to remove the gallbladder include:

Laparoscopic cholecystectomy

The general procedure includes:

• The surgeon makes a number of small incisions into your abdomen, so that slender instruments can reach into the abdominal cavity.
• A tube blowing a gentle stream of carbon dioxide gas is inserted. This separates the abdominal wall from the underlying organs.
• The surgeon views the gallbladder on a TV monitor by using a tiny camera attached to the laparoscope.
• Special x-rays (cholangiograms) during the operation can check for gallstones wedged in the bile ducts.
• The ducts and artery that service the gallbladder are clipped shut. These clips are permanent.
• The gallbladder is cut free using either laser or electrocautery
• The gallbladder, along with its load of gallstones, is pulled out of the body through one of the abdominal incisions.
• The instruments and the carbon dioxide gas are removed from the abdominal cavity. The incisions are sutured (closed up) and covered with dressings.

Open gallbladder surgery

The general procedure is the same as for laparoscopic surgery, except that the surgeon reaches the gallbladder through a large, single incision in the abdominal wall. Sometimes, an operation that starts out as a laparoscopic cholecystectomy turns into open surgery if the surgeon encounters unexpected difficulties, such as not being able to see the gallbladder properly.