Laparoscopic Cholecystectomy

Cholecystectomy

Cholecystectomy is a surgical procedure to remove your gallbladder - a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. Your gallbladder collects and stores bile - a digestive fluid produced in your liver.
Cholecystectomy may be necessary if you experience pain from gallstones that block the flow of bile. Cholecystectomy is a common surgery, and it carries only a small risk of complications. In most cases, you can go home the same day of your cholecystectomy.
Cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. Doctors call this laparoscopic cholecystectomy. In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy.

Cholecystectomy

Gallbladder Disease Symptoms

Stones can form in the gallbladder. These stones can move and block the cystic duct and severe pain. This pain is located mainly in the right side of the abdomen after you eat fatty foods. Stones could also cause nausea, vomiting, fever and infection. If the stone moves to the common bile duct and gets stuck, it can cause pain, yellowish, discoloration of the skin called jaundice and inflammation.
Sometimes, patients suffer from similar symptoms of pain and discomfort even though there are no gallstones. In these cases, the gallbladder may not be functioning properly. Doctors can order special radiological tests to check the function of the gallbladder.
Gallstones are the most common cause of gallbladder disease. Gallstones occur when bile forms solid particles (stones) in the gallbladder.

  • The stones form when the amount of cholesterol or bilirubin in the bile is high.
  • Other substances in the bile may promote the formation of stones.
  • Pigment stones form most often in people with liver disease or blood disease, who have high levels of bilirubin.
  • Poor muscle tone may keep the gallbladder from emptying completely. The presence of residual bile may promote the formation of gallstones.

Risk factors for the formation of cholesterol gallstones include the following:

  • Female gender,
  • Being overweight,
  • Losing a lot of weight quickly on a "crash" or starvation diet, or
  • Taking certain medications such as birth control pills or cholesterol lowering drugs.

When the gallbladder or gallbladder ducts become inflamed or infected as the result of stones, the pancreas frequently becomes inflamed too.

  • This inflammation can cause destruction of the pancreas, resulting in severe abdominal pain.
  • Untreated gallstone disease can become life-threatening, particularly if the gallbladder becomes infected or if the pancreas becomes severely inflamed.

Gallbladder Disease Treatments

Most people who have “silent” gallstones in the gallbladder don't require treatment. People with intermittent pain can try avoiding or reducing their intake of fatty foods. Diet changes can sometimes help with the symptoms.
Antibiotics can help treat the infection but they do not eliminate the stones.
Some of the risk factors for gallstone formation can be modified, such as obesity. By maintaining a healthy weight through proper diet and exercise, a person can reduce the chances for gallstones. People with diabetes tend to have a higher risk for gallstones, so keeping weight under control may prevent gallstones from developing. A low-carbohydrate diet and regular physical activity may help prevent gallstones. Also, one should avoid diets that result in losing weight very quickly as risk of developing gallstones will increase.
If someone has gallstones in the gallbladder that cause repeated attacks of pain, the doctor may recommend removing the gallbladder. This type of surgery is called a cholecystectomy.
Taking the gallbladder out, however, is frequently necessary to control the symptoms. Most of the bile made by liver flows directly to the intestine and in not stored in the gallbladder. This is why, when gallbladder is removed, the juices made in the liver can still flow to the intestines and help with digestion.

Cholecystectomy Surgeries

There are two ways to take out the gallbladder. One method uses a big skin incision known as ‘open cholecystectomy’.
The other method is done with scopes and smaller incisions. It is known as ‘laparoscopic cholecystectomy’.
The benefits of laparoscopic operation are a faster recovery period and shorter hospital stay. Unfortunately not everybody is a candidate for laparoscopic surgery. For example, patients who have had previous surgeries in their abdomen may not be able to have this procedure.
The laparoscopic and open surgeries are performed under general anesthesia. In the open surgery, the surgeon makes an incision in the upper abdomen. The peritoneum or abdominal cavity is then entered. Finally the gallbladder is removed. With the ‘laparoscopic’ operation, the abdominal cavity is filled with a special gas. Making multiple small incisions, scopes are inserted in the abdominal cavity. The gallbladder is then taken out by separating from the common bile duct.

Cholecystectomy Risks and Complications

This surgery is very safe. There are however, several possible risks and complications. These are unlikely but possible. The risks and complications include those related to anesthesia and those related to any type of surgery. And some are related specifically to this surgery. Structures in the abdomen could be damaged. Such problems can include the following: the liver and the common bile duct could be injured. Injury to the bile duct could lead to leakage of the bile into the peritoneal cavity and even to the outside.