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Cholecystectomy: A Laparoscopic Surgical Procedure Guide

Written by:

Aditya Gupta

blog for Laparoscopic Surgical Procedure Guide
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In medical parlance, cholecystectomy is the surgical procedure attempted to remove gallbladder. The primary reason for conducting cholecystectomy is gallstones as they may cause acute pain in the abdomen. This discomfort, termed biliary colic, is triggered by blockage of the bile or cystic duct.

A quick recollection of your school-time education may help you recall the function of this tiny pear-shaped organ also known as the gallbladder.

The Gallbladder

Albeit small, the gallbladder, positioned comfortably under the liver, plays an essential role in collecting and storing bile that is produced by the liver. On an average, the liver produces around three to four cups of bile. Bile is a yellowish, bitter-tasting liquid that aids in digesting fats. When fatty foods are ingested, the gallbladder releases bile into the small intestine through a duct. This process helps in digestion by breaking down the fat and removing the waste.

gallbladder under the liver

What Are Gallstones

As the name suggests, Gallstones are stones or lumps or tiny pebbles of hardened digestive fluid. They can form in the gallbladder or even in the bile duct. The gallstones vary in size. For instance, there can be one large gallstone of the size of a golf ball or hundreds of gallstones as tiny as a speck of sand. Though, usually, they are said to be around 5-10 mm in diameter.

Cholelithiasis is the medical term for formation of gallstones. It is called choledocholithiasis if gallstones develop in the bile duct. Moreover, gallstones in the pancreas may cause inflammation, giving rise to a condition called pancreatitis.

Not all gallstones need surgical removal. However, some may cause the gallbladder to inflame, triggering infection and excruciating pain. This is defined as cholecystitis which could be chronic if it develops over a period of time or acute if it is a sudden development.

Gallstones are stones of hardened digestive

Symptoms of Cholecystitis

  • Pain in the back, between the shoulder blades to be precise
  • Aching in the right shoulder
  • Sharp, unbearable pain in the right abdomen
  • Sudden pain in the centre of abdomen that may rapidly become unbearable
  • Nausea
  • Bloating
  • Vomiting
  • Yellowing of skin (jaundice): This happens when gallstones are formed in the common bile duct

Cholecystitis can be diagnosed after physical examination by a general practitioner who may then advise the patient to consult a specialist. There are a number of tests that the patient may be required to undergo before opting for cholecystectomy.

Cholecystitis

A patient may need to undergo some tests before the surgery, for instance abdominal ultrasound, urinalysis, blood work evaluation, and so on and so forth. Your healthcare provider, may need you to help them with your health background, medical history, medications.

Why Cholecystectomy

The surgical procedure of removing the gallbladder is the recommended technique to alleviate the pain caused by gallstones.

Standard procedure for treating the pain arising out of any of the severe conditions caused by gallstones comprises pain medication, IV fluids, and an eventual cholecystectomy. Doctors may advise you about the precautions to be taken after the operation.

Surgical procedure of removing gallbladder

Laparoscopic Cholecystectomy

Cholecystectomy laparoscopic surgery is the preferred method opted by quite a lot of medical professionals since it is minimally invasive. This is performed by making several small incisions on the abdomen. Thereafter, hollow tubes called ports are inserted via the openings. Post this, a tiny video camera and surgical tools are inserted into the tubes. For a better view of the internal organs, the abdomen is inflated with carbon dioxide. The inserted camera displays the image on a monitor. This aids the surgeon in manoeuvring the surgical instruments to operate and remove the gallbladder.

After the removal of the gallbladder, doctors suture the incisions. They may also use glue or surgical clips for this purpose. The procedure may take about 1 to 2 hours.

Cholecystectomy laparoscopic surgery

Postoperative Care

In some cases, patients are allowed to go home the same day after the effect of the drugs wear off. However, some may need to stay for a night or two. The recovery usually takes about a week's time.

postoperative care after surgery

Open Cholecystectomy

In open cholecystectomy, the surgeon makes a 6-inch long incision in the abdomen on its upper right-hand side. This cuts through the muscle and the fat so as to pull them aside to reveal the gallbladder. The organ is removed and the ducts are closed. The opening is then sutured or stapled with surgical clips. For some time, doctors may put little channel passing through the inside the abdomen with an opening on the surface which is then removed during the patient's stay at the hospital. This procedure may go about for 1 to 2 hours.

long incision in the abdomen

Postoperative Care

A patient may be asked to stay at the hospital for two to three weeks. You may be asked to go home after the doctors are satisfied with your recovery; mostly your ability to digest fluids and solids without any pain, and move around without any assistance.

After Surgery Discomforts, Complications

Some patients may complain of the following complications post cholecystectomy. Doctors, however, dub them as minor risks or symptoms and advise their patients to immediately consult them if the condition/s persist.

After cholecystectomy
  • Blood clots
  • Bleeding from abdominal cavity
  • Heart problems
  • Bile leakage
  • Injury to the bile duct
  • Pancreatitis
  • Pneumonia
  • Injury to bile duct, liver, bowel, blood vessels, small intestine owing to their proximity to the organ
  • Infection

Benefits Outnumber Risks, Contraindications

  • Cholecystectomy is said to relieve you of severe pain and inflammation that may later develop into a chronic infection.
  • It may stop re-occurrence of gallstones.
  • By not getting operated, you may risk bursting of the gallbladder, acute illness.
  • In worst cases, it can cause worsening symptoms and eventual fatality.
cholecystectomy Risks

So, this was hopefully all you needed to know about cholecystectomy. If you have any complications related to gallbladder, it is advisable to consult a doctor as soon as possible as any delay will only result in the further worsening of your condition and overall wellbeing.

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