Gallbladder Removal

Gallbladder Removal

Gallbladder Removal: Purpose, Risks, and Procedure

Gallbladder stones are very common and surgical intervention is usually advised to treat this problem. Cholecystectomy is the surgical removal of the inflamed or problematic gallbladder. To understand the purpose, risks, and the procedure, let us review the following information on the gallbladder, gallstones, and the procedure itself.

About the Gallbladder

The gallbladder is the small pear-shaped sac that lies under the liver in the right upper abdomen. It stores the bile produced by the liver and is responsible for proper digestion of lipids or fats.

The liver produces about 3 to 5 cups of bile every day. The bile travels through the common hepatic (liver) duct and the cystic duct, and finally to the gallbladder for temporary storage. When we eat food, especially those that are high in fats, the gallbladder secretes the bile into the small intestine.

About Gallstones

Cholelithiasis, the medical term for the formation of gallstones, is usually associated with a diseased gallbladder that is not functioning correctly. Gallstones are stone-like debris that are formed from the bile stored in the gallbladder. They vary in color, shape, and sizes. The most common type mainly consists of excess fats called cholesterol. They may also enlarge over the years or may be squeezed out of the gallbladder into the duct. Gallstones in the common bile duct are termed as Choledocholithiasis.

Gallstones that are stuck in the ducts can block the flow of the bile or cause Cholecystitis – the inflammation of the gallbladder.

Signs and Symptoms of Gallstones

The presence of gallstones may cause any of the following depending on the severity:

  • Pain on right abdomen
  • Fever
  • Nausea or Vomiting
  • Bloating, heartburn, or indigestion
  • Yellowing of the skin (Jaundice), if the gallstones are in the common bile duct

Cholecystectomy: The Surgical Treatment for Gallstones

An operation is the only treatment for acute cholecystitis and may be recommended for gallbladder pain due to gallstones.

Purpose of Gallbladder Removal (Cholecystectomy)

While the gallbladder may not be consider as an essential organ necessary to maintain good health, the bile can cause blockage in the ducts where it usually empties causing pain and/or other medical concerns. Here are some of the most common reasons why a gallbladder removal procedure is performed:

  • To treat Cholelithiasis
  • To treat Choledocholithiasis
  • To treat Cholecystitis
  • To prevent complications
  • To prevent further attacks of pain due to gallstones

Risks of Gallbladder Removal (Cholecystectomy)

Cholecystectomy, like any other surgical procedures, has risks. However, your surgeon will do everything to prevent or minimize the risks associated with cholecystectomy.

  • Infection – infection occurs in less than one out of 1000 patients who undergo laparoscopic procedures
  • Bleeding – this is rare, but if you have chronic biliary disease, you may have a problem with clotting (anti-bleeding) factors
  • Deep Vein Thrombosis – deep vein thrombosis or blood clots in the veins may occur due to immobilization during surgery. In rare cases, it may also travel to the lungs or other parts of the body.
  • Pneumonia lack of breathing exercises, administration of general anesthesia, and immobility are possible causes of pneumonia after surgery
  • Death – this is very rare for healthy patients. Statistics say that for every 1000 patients, 0 to 1 patients die due to gallbladder removal.

The Two Types of Gallbladder Removal (Cholecystectomy)

There are two techniques to perform gallbladder removal (Cholecystectomy): Open Cholecystectomy and Laparoscopic Cholecystectomy.

Open Cholecystectomy

In an Open Cholecystectomy, the gallbladder is removed by creating an incision on the right side of the abdomen under the rib cage. If you choose to undergo an open cholecystectomy, your surgeon will create an approximately 15 – 16 centimeter incision in the upper right side of the abdomen. He/she will cut through the muscles and fats to the gallbladder. The gallbladder is then removed, and the ducts connected to it are clamped off.

Suture or staples will be used to close the site, and a small drain may be placed from the inside of the abdomen. Typically, this procedure takes about 1 to 2 hours.

Laparoscopic Cholecystectomy (Lap-Chole)

Laparoscopic Cholecystectomy also known as “keyhole” cholecystectomy, involves surgery with the use of a tiny camera that is inserted through small incisions. It is done to remove gallbladder without having to create a large opening (cut/incision) in the abdomen. A laparoscope is a narrow tube telescope with a light and video camera. This provides visualization of the gallbladder through a monitor.

The surgeon will remove the gallbladder through the small incisions. The sites are closed with surgical sutures, clips or staples, and steri-strips as necessary.

Laparoscopic cholecystectomy may take about 1 to 2 hours.

Expectations Before, During, and After Gallbladder Removal

Before Cholecystectomy

Before your scheduled cholecystectomy, be sure to inform your surgeon or healthcare staff about other medical problems you have. You may also give a list of all medications you are taking.

You should also tell your surgeon about any allergies, history of stroke or epilepsy, or if you smoke, use drugs, alcohol, and herbal medications.

On the day of your operation, you will be advised not to eat or drink for at least few hours before the surgery to reduce the risk of aspiration and other complications from anesthesia.

During Cholecystectomy

An intravenous line or IV fluid will be started to give you fluids and pre-operative medications. This medication will make you feel sleepy. Nurses and patient attendants will be sent to your room to assist you and bring you to the operating room. You’ll be given anesthesia before the surgeon performs the operation. Once the operation is done, you will be transferred to a recovery room.

After Cholecystectomy

Usually, if you do not have complications, you may go home the same day as your laparoscopic cholecystectomy. For an open cholecystectomy, hospital stay may last 2 to 3 days. Also, you will not be allowed to drive immediately after the procedure.

At home, it is important for you to monitor your condition. If you have stomach cramping, yellowing of the skin, absence of bowel movements for >3 days, vomiting, chills, severe pain, high fever, and foul odor or abnormal drainage from the incision; you should call your physician/surgeon.

It is imperative to remember that each person and his/her condition is different. The patient information written above should never replace professional advice of a surgeon who is an expert in the field. If you have questions that are not covered in the topics above, you may call and visit Pine Creek Medical Center – one of the best surgical hospitals in Dallas, Texas.

References:

  • “Bile – Wikipedia.” Wikipedia, the free encyclopedia.  <http://en.wikipedia.org/wiki/Bile>.
  • “Cholecystectomy – procedure, recovery, blood, tube, removal, pain, complications, infection.” Encyclopedia of Surgery: A Guide for Patients and Caregivers. <http://www.surgeryencyclopedia.com/Ce-Fi/Cholecystectomy.html>.
  • “About Cholecystectomy: Surgical Removal of the Gallbladder.” Oxford University Hospitals.  <http://www.ouh.nhs.uk/patient-guide/leaflets/files/cholecystectomy.pdf>.
  • “Cholecystectomy: Surgical Removal of the Gallbladder.” American College of Surgeons.  <http://www.facs.org/~/media/files/education/patient%20ed/cholesys.ashx>.
  • “A Guide to Gallbladder Surgery.” MUHC Patient Education | MUHC.  <http://www.muhcpatienteducation.ca/DATA/GUIDE/231_en~v~gallbladder-surgery.pdf>.

 

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