Gallbladder surgery

Gallbladder removal is a surgery to remove the gallbladder via a single, large open incision in the abdomen. It’s also called open cholecystectomy. Doctors perform the procedure to provide permanent relief to a person with gallstones and other problems associated with the gallbladder.

Here are some FAQs answered!

What is laparoscopic cholecystectomy?

The process of surgically removing the gallbladder is called cholecystectomy. With the use of advanced technology in laparoscopy today, it is possible to remove gallbladder via a tiny incision in the navel. Today LC or Laparoscopic Cholecystectomy is the most preferred treatment all over the world when operating on symptomatic gallstones.

Tell me more about the gallbladder

The gallbladder is an organ that is located just below the upper right abdomen. The gallbladder is responsible for concentrating and collecting digestive liquid oozed by the liver. Also known as bile, the constituent moves via the narrow tubular channels into the small intestine.

What are gallbladder problems and its causes?

The presence of gallstones can be a strong cause for gallbladder problems. Excessive cholesterol in bile could cause gallstones. However, it is not very clear as to why gallstone forms in some people. There are no known cures for preventing gallstone. When this gallstone blocks the bile duct, it can cause jaundice.

How to diagnose gallstones?

Gallstones are usually diagnosed with the help of ultrasound. In other complex cases, x-ray may be taken to evaluate the severity of gallbladder disease. Gallstones do not disappear naturally. While some can be managed temporarily with drugs, the others are prevented by dietary adjustments like reducing the intake of fat. However, the success rate is very short-termed and low as well.

Cholecystectomy is the surgical removal of the gallbladder. It is a common treatment of symptomatic gallstones and other gallbladder conditions. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older, more invasive procedure, called open cholecystectomy.

What is laparoscopic cholecystectomy procedure?

Laparoscopic cholecystectomy requires several (usually 4) small incisions in the abdomen to allow the insertion of operating ports, small cylindrical tubes approximately 5 to 10 mm in diameter, through which surgical instruments and a video camera are placed into the abdominal cavity. The camera illuminates the surgical field and sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through the operating ports.

The 1-week-old incisions of a post-operative laparoscopic cholecystectomy patient are indicated by red arrows. The 3 abdominal incisions are approximately 6 mm, while the fourth incision near the umbilicus is 18 mm, each closed with dis-solvable sutures.

What is open cholecystectomy?

Open cholecystectomy is occasionally performed in certain circumstances, such as failure of laparoscopic surgery, severe systemic illness causing intolerance of pneumoperitoneum, or as part of a liver transplant. In open cholecystectomy, a surgical incision of approximately 10 to 15 cm is typically made below the edge of the right ribcage. Open cholecystectomy is associated with greater post-operative pain and wound complications such as wound an infection and incisional hernia compared to laparoscopic cholecystectomy, so it is reserved for select cases.

What are the benefits of laparoscopic cholecystectomy?

  • The post-operation pain is reduced to a great deal.
  • Unlike the usual five to seven inch incision, the actual operation requires only four tiny openings in the stomach.
  • Recovery is usually faster here when compared with open gallbladder surgery.
  • Usually, patients go home within a day after surgery and enjoy normal life in a very short time.

What are the procedural risks and complications?

Laparoscopic cholecystectomy does not require the abdominal muscles to be cut, resulting in less pain, quicker healing, improved cosmetic results, and fewer complications such as infection and adhesion. Most patients can be discharged on the same or following day as the surgery and can return to any type of occupation in about a week.

Abdominal peritoneal adhesions, gangrenous gallbladders, and other problems that obscure vision are discovered during ~ 5% of laparoscopic surgeries, forcing surgeons to switch to the standard cholecystectomy for safe removal of the gallbladder. Adhesions and gangrene can be serious but converting to open surgery does not equate to a complication.

During laparoscopic cholecystectomy, gallbladder perforation can occur. Infected bile, pigment gallstones, male gender, advanced age, perihepatic location of spilled gallstones, more than 15 gallstones and an average size greater than 1.5 cm have been identified as risk factors for complications. Spilled gallstones can be a cause significant morbidity to the patient. Postcholecystectomy syndrome.

How do you need to prepare yourself before the surgery?

Prior to the operation, you need to attend an appointment of pre-assessment of your health condition. This assessment may require general checkup of different health conditions and a blood test to ensure that you are completely ready for the surgery.

The surgeon might want to check if you have developed gallstones or inflammation in the bile duct in which case, open surgery might be recommended.

Recovery after a gallbladder surgery

Being a major operation associated with the abdomen, there are chances for a certain amount of prospective pain. There could be an occurrence of vomiting and nausea. After the diet or liquid is tolerated, the patient can exit the hospital on the same day or the day after. Other activities largely depend on the patient’s feeling. Patients are encouraged to walk and showering is also allowed, a day after the operation.

A week’s time should be the ideal time for patient’s return to normal life. Things like driving, lifting of light objects, walking up stairs can be followed after that. One must understand the process of recovery is slow.

You must also understand that there are chances for complications. If you experience symptoms like yellow skin or eyes, fever or pain in the abdomen drainage or vomiting problems, contact your surgeon immediately.

Dr. Nanda Rajaneesh has over 18 years of experience in surgical oncology and laparoscopic surgery. She is currently a visiting consultant in both Apollo Spectra Hospitals and Sakra World Hospital. She has operated many film stars & VIPS, both at regional and national level.