Key Pointers:
- Both surgeries remove the gallbladder to treat gallstones and related problems.
- The main difference lies in the size of the incision and recovery time.
- Keyhole (laparoscopic) surgery uses small cuts, while open surgery involves a larger incision.
- Most patients recover faster from keyhole surgery, but open surgery may be needed in complex cases.
- A qualified surgeon will recommend the safest approach for your condition.
When Gallstones Call for Surgery
Gallstones are common, and for many people, they don’t cause symptoms at first. But when these stones block the bile duct, pain can become intense and constant, often felt on the upper right side of the abdomen or after a heavy meal.
When this happens, surgery to remove the gallbladder (called a cholecystectomy) may be recommended. The next question many patients ask is: Should I have keyhole surgery or open surgery?
Understanding the difference helps you make an informed decision together with your surgeon.
What Happens in Keyhole (Laparoscopic) Gallbladder Surgery
In keyhole surgery, small incisions, usually three to four, are made on the abdomen. A thin camera and surgical instruments are inserted through these openings to remove the gallbladder.
Because the cuts are small, this approach generally leads to:
- Less pain after the operation
- Shorter hospital stay (often discharged within a day or two)
- Smaller scars and faster recovery
Patients can typically return to light activity within a week and resume normal routines in about two to three weeks.
However, keyhole surgery might not always be possible, especially if there is severe inflammation, infection, or scar tissue from previous surgeries. In such cases, your surgeon may recommend or switch to an open procedure for safety.
What Happens in Open Gallbladder Surgery
Open gallbladder surgery involves making a single larger incision (about 10–15 cm) below the right ribcage. Through this opening, the surgeon removes the gallbladder directly.
This method may be chosen if:
- The gallbladder is badly inflamed or infected
- There is bleeding or scarring around the organ
- Previous abdominal surgeries make keyhole access difficult
- The patient has certain medical conditions requiring a clearer surgical view
Open surgery generally means a longer recovery time, patients may stay in the hospital for several days and take about four to six weeks to return to full activity.
How Surgeons Decide Which Approach to Use
The choice isn’t always about which method is “better,” but rather which is safer and more appropriate for your condition.
Factors your surgeon will consider include:
- Your overall health and medical history
- The severity of gallbladder inflammation or infection
- Findings during imaging tests like ultrasound or CT scan
- The presence of other abdominal issues
Some surgeries start as keyhole procedures but are converted to open surgery if complications are found during the operation. This decision is made on the spot for patient safety.
Recovery and What to Expect After Surgery
After a keyhole procedure, patients often go home the same or next day. Pain is usually mild and can be managed with oral medication. Normal eating can resume gradually once nausea settles.
For open surgery, recovery takes longer, and the hospital stay is typically three to five days. Patients are advised to avoid heavy lifting or strenuous activity for several weeks to allow healing.
Regardless of the method, follow-up visits are important to check wound healing and ensure no complications, such as infection or bile leakage.
Frequently Asked Questions
- Is keyhole gallbladder surgery always possible?
Not always. If the gallbladder is severely inflamed, infected, or scarred, open surgery may be safer and more effective. - Does keyhole surgery cost more than open surgery?
Costs depend on several factors, including hospital stay and surgical complexity. While keyhole surgery may have a higher procedure fee, shorter recovery and fewer hospital days can balance overall costs. - Can I live normally without a gallbladder?
Yes. The gallbladder stores bile, but your body can still digest food without it. Some people may have mild changes in digestion initially, which usually resolve over time. - How soon can I return to work after surgery?
Most patients return to work within one to two weeks after keyhole surgery, while open surgery may require up to six weeks of recovery, depending on your job and healing progress.
Key Takeaways
- Both keyhole and open surgeries remove the gallbladder effectively.
- Keyhole surgery usually means smaller cuts and faster recovery.
- Open surgery is reserved for more complicated or high-risk cases.
- Your surgeon’s recommendation is based on safety and your unique medical situation.
- Early consultation helps you plan for the right treatment at the right time.
Need Clarity on Your Gallbladder Surgery Options?
If you’re dealing with gallstone pain or have been advised to consider surgery, it’s important to understand which approach suits your condition best.
Book a consultation with Dr Lee Lip Seng at LS Lee Surgery Clinic to discuss your options for gallbladder removal, including keyhole and open surgery methods.
Dr Lee is a Senior Consultant Surgeon specialising in the liver, gallbladder, pancreas, hernia, and general surgery. Together, you can make an informed decision that prioritises your safety and recovery.
