A small incision is made either in the gallbladder itself or in the cystic duct to allow insertion of a small tube or catheter. Dye is injected through this catheter to allow visualization of the bile ducts and insure that no stones are present within the bile duct on an x-ray screen. If there are no stones present in the bile duct, the cystic duct is divided after sealing it with metallic clips. The cystic artery is clipped and divided and the gallbladder is removed from the bed of the liver with a cautery device or laser. The patient is able to eat immediately after waking from surgery and is usually discharged home that day or the next.
Most patients return to normal activities within one to two weeks of their procedure.
If a stone is found in the common bile duct, most may also be removed during the laparoscopy. These stones can be flushed through the bile duct and into the bowel where they will pass without further problems. If they are not flushed easily, access to the bile duct can be gained through the cystic duct by dilating it up to a size big enough to allow passage of a small scope known as a choledocho scope. The choledocho scope allows doctors to see within the bile duct and the stones can be grasped with small baskets and removed. Rarely, if the stones are impacted a small drain is left in place, and the stones are removed later at another procedure called ERCP .