Gallbladder Surgery

Gallbladder surgery is one of the most commonly performed laparoscopic surgical procedures. Gallbladder surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy.

The gallbladder is situated on the undersurface of the liver on the upper right side of your abdomen. Its main purpose is to collect and concentrate bile produced by the liver.

A cholecystectomy may be necessary if you experience pain from gallstones that block the flow of bile.

We perform the cholecystectomy by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder, This is called laparoscopic cholecystectomy.

During a laparoscopic cholecystectomy a tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in your abdomen to remove your gallbladder.

Then your incisions are sutured, and you’re taken to a recovery area. A laparoscopic cholecystectomy takes one or two hours.

A laparoscopic cholecystectomy isn’t appropriate for everyone. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or complications. This is called an open cholecystectomy.

A cholecystectomy is  performed to treat gallstones and the complications they cause. We  recommend a cholecystectomy if you have:

  • Gallstones in the gallbladder (cholelithiasis)
  • Gallstones in the bile duct (choledocholithiasis)
  • Gallbladder inflammation (cholecystitis)
  • Pancreas inflammation (pancreatitis) due to gallstones

Risks

A cholecystectomy carries a small risk of complications including:

  • Bile leak
  • Bleeding
  • Blood clots
  • Heart problems
  • Infection
  • Injury to nearby structures, such as the bile duct, liver and small intestine
  • Pancreatitis
  • Pneumonia

Your risk of complications depends on your overall health and the reason for your cholecystectomy.

How you prepare

To prepare for a cholecystectomy, we ask you to:

  • The night before your surgery ou may eat a sup and drink water with your medications, but avoid eating and drinking at least four hours before your surgery.
  • Stop taking certain medications and supplements. Tell your doctor about all the medications and supplements you take. Continue taking most medications as prescribed.

Prepare for your recovery

Plan ahead for your recovery after surgery. For instance:

  • Plan for a hospital stay. Most people go home the same day of their cholecystectomy, but complications can occur that require one or more nights in the hospital so we prefer you stay in the hospital for one night. We suggest you to bring personal items, such as your toothbrush, comfortable clothing, and books or magazines to pass the time.
  • Find someone to drive you home and stay with you.

After a cholecystectomy

How quickly you can return to normal activities after a cholecystectomy depends on which procedure your surgeon uses and your overall health. People undergoing a laparoscopic cholecystectomy may be able to go back to work in a matter of days. Those undergoing an open cholecystectomy may need a week or more to recover enough to return to work.

FAQ

What are signs and symptoms of gallbladder pain?

Gallbladder pain may vary or feel different depending on the cause. Many people with gallstones never experience pain. However, there are some variations in gallbladder pain that help the doctor to make a diagnosis. The main signs and symptoms include: pain, nausea, vomiting, digestive problems, fever, chills, chronic diarrhea, jaundice, unusual stools or urine.

Can gallbladder polyps be a life threat?

Polyps are abnormal tissue growths that can develop in the gallbladder. Usually they are typically benign (noncancerous). Small gallbladder polyps (< 10 mm) may not need to be removed. In most cases, they don’t create any risk to you or your gallbladder, but larger polyps (> 10 mm) may need to be surgically removed before they develop into cancer or cause other problems.

Which tests, procedures and exams are necessary to confirm that you are having trouble with your gallbladder?

To identify possible causes for the symptoms you are experiencing, your doctor will first request your medical history and then complete a physical exam. As part of the exam, the doctor will ask you to give a detailed description of the symptoms you are experiencing, so it is helpful to keep track of what you feel, how long the symptoms have lasted, and the location of discomfort. When gallstones are suspected, routine liver blood tests are helpful. Other diagnostic procedures used to identify and diagnose gallbladder disorders include: abdominal ultrasound, Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic ultrasound (EUS) and Endoscopic retrograde cholangiopancreatography (ERCP).

Why does my gallbladder need to be removed?

Cholecystectomy (gallbladder removal) is usually carried out if you have symptomatic gallstones disease. Gallstones often cause no symptoms and you may not realise you have them, but occasionally they can block the flow of bile and irritate the gallbladder (acute cholecystitis) or pancreas (acute pancreatitis) or choledocholithiasis (when gallstones have moved to the common bile duct and doesn’t allow the gallbladder or rest of the biliary tree to drain). This can cause symptoms such as: sudden and intense abdominal pain, feeling and being sick and Jaundice (yellowing of the skin and the whites of the eyes). Surgery to remove the gallbladder is the most effective treatment in the vast majority of cases.

What is the best surgery procedure to remove gallbladder (cholecystectomy)?

There are two main ways of removing a gallbladder: Laparoscopic cholecystectomy (several small incisions are made in your abdomen and fine surgical instruments are used to access and remove the gallbladder) and open cholecystectomy (a single, larger incision is made in your abdomen to access and remove the gallbladder). Laparoscopic cholecystectomy is used most often because you can allow to leave hospital sooner, recover faster lesser pain and are left with smaller scars than with an open surgery procedure.

What are the risks of cholecystectomy?

Gallbladder removal is considered a safe operation. Complications are rare. However, every surgical procedure carries some risks. Before the procedure, your doctor will perform a complete physical examination and medical history to minimize these risks. Risks of open gallbladder removal include: allergic reaction to anesthesia or other drugs, excessive bleeding, blood clots, damage to blood vessels, heart problems (heart attack or heart failure), infection, injury to the bile ducts or small intestine and pancreatitis.

What is laparoscopic cholecystectomy (gallbladder removal)?

Laparoscopic cholecystectomy (gallbladder removal) is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder. The gallbladder is a small organ located near your liver. It stores bile and releases bile into the small bowel to help digest fats. Normal digestion is possible without a gallbladder. Cholecystectomy is a treatment option if it becomes diseased or infected. Nowaday laparoscopic cholecystectomy is the most common type of gallbladder removal surgery.

How to prepare for a laparoscopic cholecystectomy (gallbladder removal).

You will undergo several tests beforehand to ensure that you are healthy enough for the surgery procedure. These will include blood tests, imaging exams of your gallbladder and a review of your medical history. Tell your doctor if you’re taking any medications. You may have to stop taking certain medications before surgery. Also, tell your doctor if you are pregnant or think you could be pregnant.

How a laparoscopic cholecystectomy (gallbladder removal) is performed?

The surgery procedure will be under general anesthesia and the surgeon will make four small incisions (two of 10 mm and two of 5 mm) in your abdomen. The abdomen will be inflated with gas so the surgeon has space to work. Through these incisions, the assistant surgeon will guide a tube with a small, lighted camera through the abdomen. Watching the video through a monitor, the surgeon will guide other laparoscopic tools through the holes and will remove the gallbladder. After the procedure, you will be brought to a room to recover from the anesthesia. Your vital signs will be monitored the entire time. Most people can go home at 1 postoperative day.

Is there a gallbladder removal diet I should follow?

Although a specific gallbladder removal diet doesn’t exist to recommend, general advice for avoiding problems after you have had cholecystectomy: – Eat smaller, more frequent meals (it may ensure a better mix with available bile; include small amounts of lean protein, such as poultry, fish and nonfat dairy, at every meal, along with vegetables, fruit and whole grains); – Limit fat intake (avoid high-fat foods, fried and greasy foods, and fatty sauces and gravies; instead, choose nonfat or low-fat foods); – Gradually increase the fiber in your diet (this can help normalize bowel movements by reducing incidents of diarrhea or constipation; however, it can also make gas and cramping worse. The best approach is to slowly increase the amount of fiber in your diet over a period of weeks); – Be aware that after gallbladder surgery some people find that the following are difficult to digest (caffeinated beverages and dairy products).

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