Indications for Gallbladder removal
- Symptomatic gallstone disease such as biliary colic
- Complicated gallstone disease such as acute cholecystitis or gallstone Pancreatitis
- Biliary Dyskinesia- Problem with gallbladder function without gallstones
- Gallbladder polyps- due to the risk of gallbladder cancer
- Gallbladder Cancer
Laparoscopic cholecystectomy
This is the standard technique for the removal of the gallbladder. This is a keyhole surgery involving four small incisions on the skin. A thin tube with a camera (laparoscope) is inserted through the incision close to the navel (belly button). The abdomen is then filled with carbon dioxide gas to facilitate the keyhole surgery. An x-ray of the bile ducts (operative cholangiogram) is taken during the operation to look for any stones that may have spilled out of the gallbladder into the bile ducts. The operation would take around 30-60 minutes on an average. The whole gallbladder with the stones is removed through one of the incisions.
Open surgery
In less than 1% of patients an open operation is required to remove the gallbladder. The procedure is the same as for laparoscopic surgery except that the surgeon reaches the gallbladder through a large incision in the abdominal wall. Sometimes, an operation that starts out as a laparoscopic cholecystectomy turns into open surgery if the surgeon encounters unexpected difficulties, such as not being able to see the gallbladder properly.
The possible reasons for open surgery are:
Adhesions or scarring from previous surgery
Severely inflamed or infected gallbladder
Medical conditions that would not allow key hole surgery
Suspicion of gallbladder cancer
The possible reasons for open surgery are:
Adhesions or scarring from previous surgery
Severely inflamed or infected gallbladder
Medical conditions that would not allow key hole surgery
Suspicion of gallbladder cancer
Risks of surgery
All surgery carries some degree of risk. This is a common surgical procedure with low risk generally however the risks maybe higher in elderly patients and patients with significant medical co-morbidities.
The general risks with any operation include anaesthetic risks, bleeding or infection. The risks associated with any keyhole operation include damage to structures such as your bowel, bladder or blood vessels and developing a hernia at one of the cuts.
The specific risks with the cholecystectomy include a bile leak (less than 0.2% risk) or bile duct injury (less than 0.03% risk) and may require additional corrective surgery. Retained stones in the common bile duct may require a further endoscopic procedure called an ERCP (Endoscopic retrograde cholangiopancreatography).
These risks will be discussed with you in detail at the time of the consultation.
The general risks with any operation include anaesthetic risks, bleeding or infection. The risks associated with any keyhole operation include damage to structures such as your bowel, bladder or blood vessels and developing a hernia at one of the cuts.
The specific risks with the cholecystectomy include a bile leak (less than 0.2% risk) or bile duct injury (less than 0.03% risk) and may require additional corrective surgery. Retained stones in the common bile duct may require a further endoscopic procedure called an ERCP (Endoscopic retrograde cholangiopancreatography).
These risks will be discussed with you in detail at the time of the consultation.
Your treatment journey
Initial consultation
At the initial consultation Dr Gananadha will discuss your medical history, including any pre-existing conditions that may influence decisions on surgery. The risks and benefits of surgery will be discussed as well as the expected post operative course.
Day of surgery
You will be admitted on the day of surgery. The hospital will call you prior to the surgery with time to present to hospital for admission and the fasting times. In general you can have solids till six hours prior to surgery and clear liquids till two hours prior to surgery. The operation will take approximately one hour. You will be encouraged to mobilize as soon as you are able to and eat and drink as tolerated. You may be able to get home the same day or the following day once you are able to tolerate a diet, have adequate pain relief and are mobile.
Following Discharge
Following discharge you should plan to take rest and avoid heavy lifting and physical exertion. Light activities and regular walks are encouraged. There is no special diet following this operation but you should keep it simple for the first day or two. Most people recover within one week of laparoscopic surgery. Avoid driving till you have fully recovered.
Time off from work
On average, you would need two weeks off work following surgery. Some patients may need more time off work if their work involves strenuous activities or heavy lifting. This will be discussed with you at the time of comsultation.
Follow up
Dr Gananadha will see you in the consulting rooms at four weeks post discharge for follow up.
At the initial consultation Dr Gananadha will discuss your medical history, including any pre-existing conditions that may influence decisions on surgery. The risks and benefits of surgery will be discussed as well as the expected post operative course.
Day of surgery
You will be admitted on the day of surgery. The hospital will call you prior to the surgery with time to present to hospital for admission and the fasting times. In general you can have solids till six hours prior to surgery and clear liquids till two hours prior to surgery. The operation will take approximately one hour. You will be encouraged to mobilize as soon as you are able to and eat and drink as tolerated. You may be able to get home the same day or the following day once you are able to tolerate a diet, have adequate pain relief and are mobile.
Following Discharge
Following discharge you should plan to take rest and avoid heavy lifting and physical exertion. Light activities and regular walks are encouraged. There is no special diet following this operation but you should keep it simple for the first day or two. Most people recover within one week of laparoscopic surgery. Avoid driving till you have fully recovered.
Time off from work
On average, you would need two weeks off work following surgery. Some patients may need more time off work if their work involves strenuous activities or heavy lifting. This will be discussed with you at the time of comsultation.
Follow up
Dr Gananadha will see you in the consulting rooms at four weeks post discharge for follow up.
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