Serving Ventura & Los Angeles County · Adventist Health Simi Valley (805) 577-8460

Cholecystectomy

Robotic and laparoscopic gallbladder removal for gallstones, chronic gallbladder disease, and related complications. Dr. Pakula performs this common procedure through tiny incisions so patients recover quickly and return to normal life.

About the Gallbladder

The gallbladder is a small, pear-shaped organ tucked beneath the liver in the upper right abdomen. Its role is to store bile, a digestive fluid produced by the liver that helps break down dietary fat. In many people, bile becomes concentrated over time and forms sludge or hardened deposits called gallstones. These stones can block the flow of bile, causing pain, inflammation, and potentially serious complications.

Cholecystectomy — surgical removal of the gallbladder — is the only reliably effective treatment for gallstone disease. It is one of the most commonly performed abdominal operations, and patients go on to live completely normal lives after the gallbladder is removed, as the liver continues to produce bile and the body adapts to its absence.

Recognizing Gallbladder Symptoms

Gallbladder problems produce a range of symptoms that can sometimes be mistaken for other conditions. If you experience any of the following, a physical exam and ultrasound with your doctor can help confirm whether the gallbladder is the source.

Right Upper Abdominal Pain
Pain or pressure under the right ribcage, often occurring after fatty meals and lasting minutes to hours.
Back & Shoulder Pain
Referred pain to the right shoulder blade or mid-back, a characteristic pattern of gallbladder attacks.
Nausea & Indigestion
Persistent nausea, bloating, belching, or a feeling of fullness particularly after eating.
Heartburn & Epigastric Pain
Burning pain behind the sternum or in the upper central abdomen that does not respond to antacids.
Jaundice
Yellowing of the skin or whites of the eyes, indicating a stone has migrated into the bile duct and requires prompt attention.
Fever & Chills
Signs of infection indicating acute cholecystitis — an inflamed gallbladder that typically requires urgent surgical evaluation.

Diagnosis

Gallbladder disease is straightforward to diagnose when the right tests are performed. Dr. Pakula will review your symptoms and order the appropriate workup to confirm the diagnosis before recommending surgery.

1
Physical Examination
Assessment of abdominal tenderness, particularly in the right upper quadrant. Murphy's sign — pain on deep inhalation during palpation — is a classic indicator of gallbladder inflammation.
2
Abdominal Ultrasound
The primary imaging tool for detecting gallstones, gallbladder wall thickening, and bile duct dilation. Safe, non-invasive, and highly accurate for gallstone disease.
3
Blood Tests
Liver function tests, bilirubin, and inflammatory markers help identify infection, bile duct obstruction, and pancreatitis caused by a migrated stone.

The Procedure

Dr. Pakula performs cholecystectomy laparoscopically or robotically, depending on the patient's anatomy and clinical situation. Both approaches use small incisions rather than a large open cut, with a camera and specialized instruments inserted through ports to visualize and remove the gallbladder.

The robotic approach provides Dr. Pakula with three-dimensional visualization and enhanced instrument dexterity, which is particularly useful in cases where inflammation has distorted the normal anatomy around the bile duct. Careful identification of the bile duct before dividing any structures is the most critical step in the procedure and is a primary focus of Dr. Pakula's technique.

Most patients go home the same day or the following morning and return to light activity within a week. The liver continues to produce bile and drains directly into the small intestine, so digestion is not meaningfully affected after recovery.

What to Expect

Same-Day or Overnight
Most patients are discharged the same day or after one night in hospital.
1 Week Light Activity
Return to light daily activity within 5 to 7 days in most cases.
Full Recovery 2–3 Weeks
Most patients are back to full normal activity within two to three weeks.
Normal Life After
The body adapts fully. Diet returns to normal and digestion is not significantly affected long term.