GALL BLADDER SURGERY

The

gallbladder

is a pear-shaped organ that rests beneath the right side of the liver.

Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine.

Gallbladder problems are usually caused by the presence of gallstones: small hard masses consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

What are the symptoms?

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain upper abdomen which may last for few minutes to few hours associated with vomiting, indigestion and, occasionally, fever.

What if no treatment / treatment is delayed ?

Gallstones do not go away on their own. Some can be temporarily managed with drugs or by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate.If left unteated one of the complications mentioned below may occur.

Inflammation or mild infection of gallbladder ( acute cholecystitis ) to severe infection of gallbladder ( empyema ) may occur.

If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) or inflammation or infection of liver ( cholangitis ) or inflammation of the pancreas ( pancreatitis ).

Gallbladder cancer is reported in ( 1 in 1000) patients having gall stones.

So what to do?

If one has the above mentioned symptoms then get blood investigations like CBC,LFT,KFT along with Ultrasound done. In most of the cases these investigations will lead to the diagnosis of gall stones. In more complex cases, some special investigations like MRCP may be required.

Symptoms will eventually continue unless the gallbladder is removed. Surgical removal of the gallbladder is the time honored and safest treatment of gallbladder disease.

Removal of the gallbladder is not associated with any impairment of digestion in most people.

What are the options available?

Medical

Medical treatment can only treat the symptoms such as pain and fever due to infection with the help of fever and antibiotics,but can not treat the disease.

Surgery

Surgery done in order to remove gallbladder is called Cholecystectomy.

Laparoscopic cholecystectomy

The surgeon must make a small cut near the belly button (navel or umbilicus) and three other small cuts to perform the surgery. These small cuts are usually closed with strong tape called “steri –strips”.

What are the benefits of laparoscopic surgery?

Very little of the muscles in the abdominal wall are cut during

laparoscopic surgery

. You will have less pain, less chance of forming a hernia and less chance of getting an infection. There is less scarring with the laparoscope which many patients like. You will be able to go back to your normal activities and to work much quicker.

Open Cholecystectomy

Laparoscopic surgery cannot always be done. Bleeding disorders, a large amount of infection now or in the past, or other surgery in the same area might make the surgery too difficult through the laparoscope. In these cases, open cholecystectomy may be done by the doctor. This type of surgery requires a 7.5 to 12.5 centimeter (3 to 6 inch) cut in the abdomen. This surgery is still very common. It causes a longer cut and allows for easier access to the organs inside the abdomen. This requires a longer incision, a longer time in the hospital, and a longer time to return to your normal activities and to work.

What is required before surgery?

Blood investigations;Complete blood count,Coagulation profile,Liver function test,Kidney function,USG abdomen.The surgeon and anesthesist reviews with you,the potential risks and benefits of the operation and anesthesia are discussed respectively.You have to provide written consent for surgery and anesthesia.

How do I prepare for surgery ?

Please bring all your medication, if taking any, with you to the hospital.Follow instructions of the nursing staff .Do not eat anything for at least 6 hours before the procedure .You may be allowed to take your usual medication with sips of water.

What is the diet after surgery?

You can have normal diet soon after the operation. Most patients find they prefer light food and small meals for a few days.

When do I resume activities?

Slowly increase the activities. You can climb stairs, take a walk .Do not lift or do strenuous activity for 3-5 days for laparoscopic and 10-15 days for open procedure. Avoid driving until your pain is under control without painkillers.