Gall Bladder Operation or Cholecystectomy

A rapid recovery from this operation is typical and patients are unlikely to experience any serious complications. Minor problems are very common after this intervention so patients should be aware of these as well about the more serious complications which occur much more rarely.

The Gall Bladder and its Removal

The gall bladder is situated beneath the liver and holds bile in a small sac, bile which the liver secretes. Bile is releases in the gut to assist in the digestion of food fats whenever we have a meal. Gall stones can develop within the gallbladder and can be of various types and sizes. It is common for people in the middle of life or older to have gallstones which are not symptomatic and do not require surgery.

Gall bladder pain and inflammation can be the result of stones in some cases and stones may exit the gall bladder and lodge in the main bile duct which is the major connecting structure between the gall bladder and the liver. This can lead to jaundice, a yellow pigmentation of the skin, as the stones can block the bile duct and obstruct the flow of bile to the gut. This may be an example of where cholecystectomy may be necessary to correct the situation.

Is Gall Bladder Surgery Harmful?

The gall bladder’s function is only to store bile so its removal allows patients to live an entirely normal life in its absence. Long-term complications should not occur after cholecystectomy.

How is a Cholecystectomy Performed?

Surgeons can use the more traditional open surgical technique or the more modern laparoscopic or keyhole surgery which is the overwhelmingly more common method but about one in twenty or five percent of operations are through an open incision. This is because the surgeon decides it is safer and the most common reasons for open surgery are because the gall bladder is very inflamed or if it has a lot of adhesions sticking it down to nearby organs.

Even though laparoscopic cholecystectomy is the intended type of operation, patients should be aware that they may wake up to find that the surgeon had to convert the intended technique to an open operation.

Cholecystectomy via the Laparoscope

Laparoscopic cholecystectomy involves four small incisions through which special surgical instruments are passed into the body. The surgeon is able to see inside using an instrument called a laparoscope. This is a form of telescope with a powerful light to which a miniature video camera is attached. This projects a clear image onto a TV screen allowing the surgeon to see the inside the abdomen and to find and operate on the gall bladder.

Carbon dioxide gas is pumped into the abdomen to increase the viewable space for the surgeon. The laparoscope is introduced into the abdomen through an incision below the tummy button (umbilicus) and three small incisions are made on the right hand side under the ribcage for the other instruments to be used. The gallstones and the gallbladder are removed through the incision below the umbilicus.

Cholecystectomy via Open Operation

Removal of the gallbladder via open operation sometimes cannot be performed, meaning that an open operation will have to be done. The incision is about four to six inches long below the right cage to allow the surgeon to locate the gall bladder. Then the organ can be removed and a drain inserted to drain off any excess fluid from the abdomen.

Administering the Anaesthetic

The anaesthetic is usually started by giving an injection into the hand or arm. The operation usually takes about one hour and the surgeon will often inject some long-lasting anaesthetic into the incision sites to try and make the patient as comfortable as possible afterwards.

In addition some surgeons insert a long-acting painkiller in the form of a suppository into the back passage when the patient is asleep. Patients are advised clearly about having no food for about 6 hours before the operation and nothing to drink for about 2 to 3 hours beforehand. After the operation patients can get up as soon as they feel able with a nurse making sure they can manage when they first get up.

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