This page provides clear, evidence-based information about gallbladder disease, written for patients and referring doctors, with a focus on modern minimally invasive surgery (MIS). The two most common conditions are gallstones and gallbladder polyps. Where appropriate, care is delivered using standard laparoscopic cholecystectomy, intra-operative cholangiogram (IOC), and laparoscopic transcystic bile duct exploration (LC-TCBDE) to treat bile duct stones during the same operation and reduce the need for separate procedures such as ERCP.
The gallbladder is a small organ beneath the liver that stores bile and releases it into the intestine to help digest fats. Gallbladder disease refers to conditions that affect this organ, most commonly gallstones and gallbladder polyps. Many people have no symptoms, but once symptoms develop they often recur and may lead to complications if not treated.
Gallstones are hardened deposits that form inside the gallbladder, most commonly cholesterol stones. They may remain silent, but once they cause symptoms, attacks frequently recur.
Typical symptoms (biliary colic):
Warning signs of complications (urgent review required):
Assessment is tailored to symptoms and risk of complications and may include:
Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease. It is performed through small incisions using a camera and specialised instruments.
Benefits include:
Open surgery is rarely required and is reserved for complex or unsafe anatomy where patient safety is the priority.
An IOC is an X-ray of the bile ducts performed during gallbladder surgery by injecting contrast via the cystic duct. IOC helps to:
IOC allows real-time decision-making during the operation.
What are bile duct stones?
Bile duct stones occur when gallstones pass from the gallbladder into the common bile duct. They can cause jaundice, infection, or pancreatitis and often require active treatment.
Modern minimally invasive approach
Traditionally, bile duct stones were treated with ERCP (endoscopic stone removal) as a separate procedure. While ERCP remains important in selected or urgent cases, many patients can now be managed using a single-stage minimally invasive surgical approach.
Laparoscopic cholecystectomy + IOC + LC-TCBDE
When anatomy and stone characteristics are suitable, the preferred approach in our practice is:
Advantages of this approach:
If the transcystic approach is not suitable, alternative laparoscopic or endoscopic strategies are selected based on safety and effectiveness.
Gallbladder polyps are growths arising from the gallbladder lining. Most are benign, especially when small, and are often found incidentally on ultrasound.
A small proportion of polyps may carry a risk of malignancy depending on size, growth, appearance, and patient risk factors. Management therefore follows strict international guidelines.
Based on updated European joint guidelines:
Risk factors include: age >60 years, primary sclerosing cholangitis, Asian ethnicity, sessile morphology, or gallbladder wall thickening ≥4 mm.
Temporary bloating or loose stools may occur and usually settle over time.
Management is aligned with international best practice recommendations, including guidance from SAGES, NCCN, the Tokyo Guidelines, Mayo Clinic, and updated European Society of Gastrointestinal Endoscopy / European Association for Endoscopic Surgery recommendations.
Gallbladder disease is common and highly treatable. Modern minimally invasive keyhole surgery, combined with IOC and laparoscopic bile duct stone clearance, allows safe, effective, and often single-stage treatment and reducing complications, hospital stays, and the need for multiple procedures.
If you have gallbladder symptoms, gallstones, bile duct stones, or gallbladder polyps, a specialist consultation can clarify your diagnosis and determine whether minimally invasive gallbladder surgery in Melbourne is appropriate for you.
