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after first postoperative review and surgeon clearance, with short-haul flights sometimes earlier."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":5,"max":7,"unit":"days","qualifier":"First postoperative review before flying home; pathology results discussed."}}],"indications":["Symptomatic gallstones (biliary colic)","Acute or chronic calculous cholecystitis","Gallstone pancreatitis (to prevent recurrence)","Choledocholithiasis with gallbladder in place (after duct clearance)","Gallbladder polyps of higher-risk size or features","Biliary dyskinesia in selected patients","Porcelain gallbladder or suspected gallbladder malignancy"],"main_risks":["Bile duct injury","Bile leak","Bleeding","Infection (wound or intra-abdominal)","Injury to bowel or other organs","Retained common bile duct stones","Conversion to open surgery","Port-site hernia","Anesthesia-related and thromboembolic complications","Post-cholecystectomy diarrhea or persistent symptoms"],"pain":"Moderate pain for the first few days, including incisional and shoulder-tip pain from gas; usually controlled with oral analgesics.","preparation":["Preoperative assessment and blood tests","Abdominal ultrasound imaging review","Fasting before anesthesia per anesthesia team instructions","Review of medications and allergies with the surgical team","Arrange transport and adult support after discharge"],"recovery_timeline":[{"phase":"Day 0-2","description":"Recovery from anesthesia, early mobilization, diet resumed as tolerated, discharge same day or next day.","restrictions":["No driving while on opioid analgesics","Avoid heavy lifting"]},{"phase":"Days 3-14","description":"Pain decreases; return to light daily activities and desk work.","restrictions":["Avoid heavy lifting and strenuous exertion"]},{"phase":"Weeks 2-6","description":"Gradual return to full activity and exercise as cleared by surgeon.","restrictions":["Avoid heavy lifting until cleared by surgeon"]}],"rehabilitation_days":{"min":7,"max":21,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated laparoscopic cholecystectomy; no formal rehabilitation program is usually needed."},"result_longevity":"Permanent; the gallbladder is removed so gallbladder stones cannot recur, though bile duct stones can rarely form later.","revision_rate_pct":{"min":1,"max":4,"unit":"percent","qualifier":"Conversion to open surgery or reoperation/reintervention such as ERCP, drainage or hernia repair; elective cases."},"scars":"Typically three or four small port-site scars of about 5-12 mm, which fade over time; a single-incision or open approach leaves different scars.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation."},"stages":[{"code":"surgery","label":"Laparoscopic cholecystectomy","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of the procedure."}}],"qualifier":"Single-stage procedure."},"success":{"metric":"Resolution of biliary colic pain after surgery","value":90,"unit":"percent of patients","horizon":"6-12 months","population":"Adults with symptomatic gallstones undergoing elective laparoscopic cholecystectomy","evidence_status":"limited"},"techniques":[{"name":"Laparoscopic cholecystectomy (standard four-port)","suits_whom":"Most patients with symptomatic gallstone disease; the standard approach.","recovery":"Often same-day or one-night stay; return to light activity within about 1-2 weeks."},{"name":"Open cholecystectomy","suits_whom":"Cases with severe inflammation, difficult anatomy, or after laparoscopic conversion.","recovery":"Longer hospital stay (several days) and recovery of about 4-6 weeks."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":0.75,"max":1.5,"unit":"hours","qualifier":"Operating time for uncomplicated laparoscopic cholecystectomy."},"initial_assessment_documents":["Abdominal ultrasound report","Recent blood test results with liver enzymes","Gallstone-related discharge or clinic summaries","List of blood thinners","Previous abdominal surgery reports (if available)","CT or MRCP report (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 5-7 days including a first postoperative review before flying home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the clinician who will do the procedure","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"Check the qualifications of the clinician who will be doing the procedure and the credentials of the facility where the procedure will be done.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check the facility's accreditation, since accreditation requires meeting published standards","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"Accrediting groups, including Joint Commission International, DNV GL International Accreditation for Hospitals, and the International Society for Quality in Healthcare, have lists of standards that healthcare facilities need to meet to be accredited.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Agree in advance how you will communicate with the clinician and carers","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"If you go to a country where you do not speak the language, determine ahead of time how you will communicate with your clinician and others who will be caring for you.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical 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offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Bleeding from wounds or inside the abdomen","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nth.nhs.uk/resources/cholecystectomy/","host":"nth.nhs.uk","quote":"Bleeding. You may develop bleeding inside your abdomen or from your wounds post operatively.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Yellowing of eyes and skin","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nth.nhs.uk/resources/cholecystectomy/","host":"nth.nhs.uk","quote":"You may suffer from symptoms of tummy pain, acid reflux (heartburn), diarrhoea or jaundice (yellowing of the eyes and skin) following removal of your gallbladder.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Leg that swells and becomes painful","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nth.nhs.uk/resources/cholecystectomy/","host":"nth.nhs.uk","quote":"This can cause your leg to swell and become painful.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Persistent vomiting and inability to tolerate food","urgency":"contact_clinic","general":false,"source":{"url":"https://dchft.nhs.uk/leaflets/patient-advice-following-laparoscopic-cholecystectomy/","host":"dchft.nhs.uk","quote":"Persistent vomiting and inability to tolerate food and drink","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":403}},{"id":"W5","text":"Increasing pain or swelling around wound sites","urgency":"contact_clinic","general":false,"source":{"url":"https://dchft.nhs.uk/leaflets/patient-advice-following-laparoscopic-cholecystectomy/","host":"dchft.nhs.uk","quote":"Increasing pain or swelling around the wound sites","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":403}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure 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