The cystic duct and the cystic artery should be identified.
After making a small incision in the cystic duct a catheter is
introduced to it and the dye will be introduced and
visualization of the cystic duct will be performed on an XRay screen.
If there are no visible gall stones in the duct the duct will be
sealed with metallic clips and separated and with another
metallic clip the cystic artery will be sealed and divided.
Then the gallbladder will be removed from the bed of the
liver with cautery device or laser. The removed gallbladder
will be taken out with one of the incisions made.
If any stones were present in the X-Ray visualization, these stones
will be flushed through the bile duct to the duodenum where it will
excrete with stools without making any problem. If this flushing
method is not sufficient to remove the stones, the choledochoscope
can be used to dilate the bile duct and to extract the stones out. Rarely
if the stones are impacted a drain is left in place and later another
surgical procedure called ERCP (Endoscopic Retrograde Cholangio
Pancreatography) will be carried out.