Cholecystectomy

Cholecystectomy

What is the Gallbladder?

The human gallbladder is a small pear-shaped organ located at the upper-right side of the abdomen hiding under the liver. It stores a combination of fluids, some fats, cholesterol, and the bile.

How Does the Gallbladder Work?

The gallbladder’s principal function is to store bile, a substance that helps the digestive system in breaking down fats from the food we eat. The liver produces this substance (the bile) and sends them to the gallbladder for storage. Each day, about 3 to 5 cups of bile is produced by the liver. When we eat fatty cuts of pork, beef, dark chicken meat or high-fat dairy foods, the gallbladder squeezes out the stored bile through its small ducts towards the small intestine.

What is a Cholecystectomy?

Cholecystectomy is a procedure used to remove a diseased/ non-functioning/ infected, or sick gallbladder. It is also done to surgically remove a gallbladder with gallstones to stop pain or infection.

Why Undergo a Cholecystectomy?

Gallbladder stones are very common these days, and cholecystectomy is often the only solution to this problem. Gallstones are fragments formed from bile that varies in shape, size, and color.  They may cause infection of the gallbladder (Cholecystitis), abdominal tenderness, and pain that usually starts near the belly button or the right side of the abdomen.

Cholecystectomy is performed to treat gallstones and prevent any complications that they may cause. Your surgeon may suggest cholecystectomy if there is:

  • Gallbladder inflammation (Cholecystitis)
  • Gallstones in your gallbladder (Cholelithiasis)
  • Gallstones in your bile duct (Choledocholithiasis)
  • Gallstones causing inflammation of the pancreas (Pancreatitis)

What Happens Before a Cholecystectomy?

To be sure of the diagnosis and the need for gallbladder removal, your physician will ask you about the pain and other stomach problems that you may feel. He/she will also do a physical assessment or request further testing.

Additional tests may include any of the following: complete blood count, blood chemistry, coagulation profile, ultrasound, Hepatobiliary scan, Endoscopic retrograde cholangiopancreatography (ERCP), and MRI.

If you have other medical conditions or if you are taking any medications, be sure to inform your doctor to avoid complications.

What Happens During a Cholecystectomy?

You will be brought to the surgical unit/operating room and will be put under general anesthesia.

Currently, there are two main techniques to perform a cholecystectomy:

  • Open Cholecystectomy – This is done by creating a 6-inch incision along the abdomen’s upper right side. Then, the surgeon will cut through the muscles and the fat through the gallbladder. The gallbladder will be removed, and the remaining ducts attached to it will be clamped off. After that, the incision will be sutured or stapled closed. In some cases, 1 – 2 small drainage tubes may be placed in the abdomen to allow bile drainage that will be removed before discharge from the hospital.
  • Laparoscopic Cholecystectomy – Laparoscopic Cholecystectomy is a technique done by making small holes (keyholes) or incisions in the abdomen.

Typically, the surgeon inflates the abdomen with carbon dioxide to allow visualization of the internal organs. It is accomplished by placing hollow tubes or small ports in the incision. A lighted camera is used, and surgical instruments are inserted through the ports. Once the gallbladder is cut and removed, sutures or surgical glue/clips will be used to close the incisions.

Possible Risks of a Cholecystectomy

Some of the risks and complications of a laparoscopic or an open cholecystectomy include:

  • Wound Infection
  • Bleeding
  • Pneumonia
  • Heart Complication
  • Blood Clots
  • Urinary Tract Infection
  • Bile Leakage
  • Bile duct injury
  • Return to surgery
  • Pancreatitis
  • Retained Stone at common bile duct
  • Pregnancy complication/fetal distress/premature labor
  • Pneumonia
  • Injury to the nearby organs or other structures
  • Death

What Happens After a Cholecystectomy?

The procedure itself may cause you to feel uncomfortable or sore for a couple of days. You may also experience:

Pain on the surgical site – This may be felt once the effects of the anesthesia are gone. However, it is normal for any surgical procedures because the surgical wound/incision causes minimal tissue damage. To alleviate pain, your physician may prescribe pain medications as well as non-pharmacologic approaches to pain management. Because pain varies from individual to another, doses may differ per case.

Be sure to inform your surgeon if your medication doesn’t help in controlling your pain. In most cases, pain should improve each day after the operation.

Constipation – Decreased activity, anesthesia, and pain medications can contribute to the difficulty of emptying the bowels.

Be sure to drink 8-10 glasses of fluid each day (unless contraindicated) and eat vegetables, fruits, and grains because these foods are high in fiber. A diet high in fiber helps in managing constipation. Your doctor may also prescribe stool softeners and fiber supplements like Metamucil if necessary.

When to Contact Your Surgeon

Contact your surgeon/physician if you experience the following after your cholecystectomy:

  • Pain that worsens
  • Pain that doesn’t go away
  • Hyperthermia (fever) more than 101°F or 38.3°C
  • Persistent vomiting
  • Inability to eat properly
  • Jaundice (yellowing of the skin)
  • Foul smelling drainage from the incision site
  • Swelling and bleeding on from the wound site
  • No bowel movement 2-3 days post operation

Recovery

You may be advised to do deep breathing exercises to prevent complications after surgery, such as pneumonia, blood clots, or fluid accumulation in the lungs.

Most patients can resume normal activities after a few days. Others go back to work within a week or two and return to exercise after one month.

Cholecystectomy at Pine Creek Medical Center

This information about cholecystectomy is published to offer education and guidance about the surgical procedure. This article is not intended to replace a discussion with a board-certified gallbladder specialist/surgeon who is trained in managing your condition. It is also important to note that each case is different, and the outcome of any surgical procedure depends on an individual’s general condition.

Talk to your physician or book an appointment with one at Pine Creek Medical Center. You can entrust your cholecystectomy to our highly-skilled surgeons and physicians.

 


References:

  • “Anatomy Related to Cholecystectomy.” Bioline International Official Site (site up-dated regularly). Web. <http://www.bioline.org.br/pdf?ma05011>.
  • “Cholecystectomy (gallbladder removal) – Mayo Clinic.” Mayo Clinic – Mayo Clinic.  <http://www.mayoclinic.org/tests-procedures/cholecystectomy/about/pac-20384818>.
  • “Gallbladder Disease | MedlinePlus.” MedlinePlus – Health Information from the National Library of Medicine.  <http://medlineplus.gov/gallbladderdiseases.html>.
  • “Gallbladder removal – Complications – NHS.” Home – NHS. Web. <http://www.nhs.uk/conditions/gallbladder-removal/risks/>.
  • “Gallbladder Removal Surgery Information | Cleveland Clinic.” Cleveland Clinic: Every Life Deserves World Class Care. <http://my.clevelandclinic.org/health/treatments/7017-laparoscopic-cholecystectomy-gallbladder-removal>.
  • “Gallstones – Symptoms and causes – Mayo Clinic.” Mayo Clinic – Mayo Clinic.  <http://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214>.
  • Jones MW, Deppen JG. “Gallbladder, Cholecystectomy, Open.” [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Web. <https://www.ncbi.nlm.nih.gov/books/NBK448176/>
Translate »