Gallbladder Surgery (Cholecystectomy)

Cholecystectomy is commonly called gallbladder surgery and is the procedure of removal of the gallbladder. The gallbladder is a small pear shaped organ located just below the stomach. It stores bile, a digestive fluid that helps to break down fatty foods.

Conditions that require gallbladder surgery include: severe gallstones, cholecystitis (gallbladder inflammation), and pancreatitis (inflammation of the pancreas) secondary to gallstones, gallbladder cancer, and chronic acalculous gallbladder disease.

Cholecystectomy may be performed using open surgical technique or minimally invasive procedure.

Procedure

Open or Traditional surgery

This procedure is performed under general anaesthesia, and your surgeon makes a single large incision in your abdomen. Surgical instruments are inserted through this incision, muscles and tissues are dissected to expose liver and gallbladder, and then the gallbladder is removed. Later the incision is sutured and you need to be in the hospital for usually 2-5 days, after which you will be able to go home.

Laparoscopic surgery or Keyhole surgery

In this procedure, the surgeon makes several small incisions in your abdomen. Through one of the incisions a laparoscope, a small fibre-optic tube with a tiny camera, is inserted into the abdomen. Special surgical instruments are inserted through the other incisions to remove the gallbladder. You would usually be discharged after one to two days.

During cholecystectomy, cholangiography (X-ray of the bile duct) is taken to look at the bile duct for any abnormalities. If your surgeon finds stones in the bile duct, they can also be removed.

Some of the possible complications after cholecystectomy include bleeding, blood clots, wound infection, bile leakage into the abdomen, and injury to the bile duct, intestine, and blood vessels.

Advantages of Laparoscopic surgery over open surgery

Laparoscopic surgery requires shorter recovery time and hospital stay, and less pain and discomfort after surgery.

Open surgery requires longer hospital stay and recovery time, and requires longer time to operate, and causes a larger scar. Open cholecystectomy may be required in patients who have had previous abdominal surgery, due to scaring.

Post-operative instructions

  • Use of a medical device called an incentive spirometer, for breathing and to keep the lungs working
  • You will be helped getting out of bed and walking
  • Eat a normal light diet
  • Return to light work in 3 to 4 days
  • Avoid strenuous activities for few days
  • Medications to control pain
  • You will be asked to wear pressure stockings on the legs to prevent formation of blood clots

Complications of Gallbladder surgery

The most significant complication associated with the cholecystectomy surgery is bile duct injury, causing leakage of bile secretions causing pain and infection. Other complications may include excessive bleeding, damage to organs, abnormal reaction to anaesthesia and development of blood clots. Gallbladder removal does not cause nutritional deficiencies and does not require any special diet after the surgery.