Laparoscopic Cholecystectomy

Miguel A. Burch, MD
Content Author:
Pierce Campbell, Matthew Zeller DO
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Background Information: Cholecystectomy is the surgical removal of the gallbladder. This procedure may be performed via the open procedure or minimally invasive (laparoscopic or robotic). 


  • Acute Cholecystitis
  • Symptomatic cholelithiasis (biliary colic)
  • Choledocholithiasis
  • Gallbladder pancreatitis
  • Gallstone ileus
  • Mirizzi Syndrome
  • Gallbladder cancer
  • Gallbladder polyps >1cm
  • Porcelain gallbladder 

Key Anatomy:

  • Gallbladder
  • ~Fundus
  • ~Body
  • ~Neck
  • ~Infundibulum
  • Triangle of Calot (hepatocystic triangle)
  • Calot's (cystic) lymph node
  • Cystic artery
  • Cystic duct
  • Common bile duct
  • Common hepatic duct
  • Rouviere's sulcus

Surgical Risks:

General surgical risks:

  • Bleeding
  • Infection

Risks specific to Cholecystectomy 

  • Common bile duct injury (0.22% incidence for laparoscopic repairⁱ)
  • Bile leak from the transected cystic duct (0.5% incidence for laparoscopic repairⁱ)
  • Enterotomy
  • ~0.22% incidence for laparoscopic surgery²
  • Postoperative ileus
  • ~Risk lower for minimally invasive procedures vs. open

American College of Surgeons/Association for Surgical Education Core Curriculum


Online MedEd:


  • Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice by Courtney M. Townsend Jr. JR. MD
  • Zollinger's Atlas of Surgical Operations, Tenth Edition 10th Edition by Robert Zollinger, E. Ellison 
  • Atlas of General Surgical Techniques: Townsend, Evers
  • Essentials of General Surgery 5th Edition, by Peter F. Lawrence MD, Richard M. Bell MD, Merril T. Dayton MD, James C. Hebert MD FACS


  1. Fong ZV, Pitt HA, Strasberg SM, et al. Diminished Survival in Patients with Bile Leak and Ductal Injury: Management Strategy and Outcomes. J Am Coll Surg. 2018;226(4):568-576.e1. doi:10.1016/j.jamcollsurg.2017.12.023
  2. van der Voort M, Heijnsdijk EA, Gouma DJ. Bowel injury as a complication of laparoscopy. Br J Surg. 2004;91(10):1253-1258. doi:10.1002/bjs.4716