Laparoscopic
Gallbladder Removal
Laparoscopic Gallbladder Removal
Surgery to remove the gallbladder is called a laparoscopic
cholecystectomy.
With this surgery, a laparoscope (a small, thin tube with a scope
on the tip of it that is used to see the inside of your body) is
used to remove the gallbladder. Several small incisions are used
rather than one large incision.
How is a Laparoscope Used to Remove the Gallbladder?
The laparoscope is put into your body through a
tiny cut made just below your navel. Your surgeon can then see your
gallbladder on a TV screen and carry out the procedure with tools
inserted in 3 other small cuts made in the right upper part of your
abdomen. Your gallbladder is then taken out through one of the incisions.
What are the Benefits of this Type of Surgery?
With laparoscopic cholecystectomy, you may return
to work more quickly, have less pain after surgery, have a shorter
hospital stay, and have a shorter recovery time. Unlike traditional
surgery, laparoscopic surgery to remove the gallbladder can be done
without cutting the muscles of your abdomen. The incision is also
much smaller. Because the incisions are smaller with laparoscopic
cholecystectomy, there isn't as much pain after this operation as
after open cholecystectomy. Therefore recovery is faster and the
patient may return home sooner.
What are the Reasons for Gallbladder
Removal?
Several conditions may lead to surgery to remove
the gallbladder:
- Gallstones can develop if the bile gets too
concentrated. These small, hard stones can block the bile duct,
resulting in attacks of abdominal pain, nausea and fever.
- Gallstones can be extremely painful and can
lead to the gallbladder becoming infected which in turn can lead
to blood poisoning.
If the gallbladder has become inflamed and infected
it is not possible for the surgery to take place until the inflammation
has receded.
Who Should Not Have This Type
of Surgery?
If you had surgery around your gallbladder before,
if you tend to bleed a lot, or if you have any problem that would
make it hard for your doctor to see your gallbladder such as excess
weight, open surgery may be better for you. Your doctor will decide
which type of surgery is appropriate for you.
What are Possible Complications?
Complications are rare but may include bleeding,
infection and injury to the duct (tube) that carries bile from your
gallbladder to your stomach. Also, during laparoscopic cholecystectomy,
the intestines or major blood vessels may be injured when the instruments
are inserted into the abdomen. Remember, all of these complications
are rare.
Open Gallbladder Surgery
In open gallbladder surgery (cholecystectomy), the
surgeon removes the gallbladder through a 5- to 8-inch long incision
in the abdomen. This surgery is performed under general anesthesia,
and lasts 1 to 2 hours. The surgeon will make the incision either
under the border of the right rib cage or in the middle of the upper
part of the abdomen (between the belly button and the end of the
breastbone). With open cholecystectomy, you would need to stay in
the hospital for 7 days.
In about 5% of cases, a surgeon who starts a laparoscopic gallbladder
procedure needs to switch to an open surgical method. Examples of
problems that can require open rather than laparoscopic surgery
include unexpected inflammation, scar tissue, injury, or bleeding.
Conditions that may require open rather than laparoscopic surgery
include:
- Severe inflammation of the bile duct or gallbladder
- Inflammation of the abdominal lining (peritonitis)
- High pressure in blood vessels in the liver
(portal hypertension); this is caused by cirrhosis of the liver
- Being in the late stages of pregnancy
- A major bleeding disorder or use of medicines
to prevent blood clotting (blood thinners or anticoagulants)
- Scar tissue from many previous abdominal surgeries
- Abnormal anatomy in the abdomen
After Gallbladder Removal Surgery
Surgery involves a hospital stay of 5 days. Most
people can return to their normal activities within 4 to 6 weeks.
Open surgery involves more pain afterward and a longer recovery
period than laparoscopic surgery.
How Successful is the Procedure
After surgery to remove the gallbladder, bile flows
from the liver (where it is produced) through the common bile duct
and into the small intestine. Because the gallbladder is gone, bile
no longer is stored between meals. In most people, this has little
or no effect on digestion. The body can function perfectly well
without a gallbladder
Surgery reduces the risk that gallstones will come back. However,
gallstones sometimes form in the bile ducts years after cholecystectomy,
although this is not common.
|
