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GALL BLADDER

What is a Laparoscopic cholecystectomy?

Laparoscopic cholecystectomy (gall bladder surgery) is surgical removal of the gall bladder.


When is a Laparoscopic cholecystectomy performed?

A laparoscopic cholecystectomy is usually performed if one has been diagnosed with gallstones in the gall bladder.

The gall bladder is a small organ that sits under the liver.  Its function is to store bile and discharge bile into the intestine as required during food intake.

The presence of gallstones may interfere with the flow of bile, which can cause pain in the abdomen or back, nausea and vomiting or heartburn. In some cases, gallstones may lead to serious complications such as jaundice, inflammation of the gall bladder, rupture of the gall bladder, fatal infection or inflammation of the pancreas.


What happens to bile when the gall bladder is removed?

Following removal of the gall bladder, the body adapts and discharges bile from the liver into the intestine by bile ducts. 


Treatment

There are two ways in which your surgeon can remove the gall bladder : Open surgery or Laparoscopic technique.

Laparoscopic Cholecystectomy
The procedure involves making four small cuts in the abdomen.  A fiberoptic telescope is inserted into a cut made near the navel.  Carbon dioxide gas is used to inflate the inside of the abdomen to obtain a clear view of abdominal structures.  The three other cuts are for instruments.  The gall bladder is carefully cut away from the liver bed, vessels and cystic duct are tied off and the gall bladder is then removed.  At the time of the procedure, an x-ray of the duct system will be taken to find out whether there is any abnormality here or there are any stones in the ducts.

Open Surgery
Open surgery involves making a larger cut over the site of the gall bladder.  The tissue is cut in layers until the gall bladder is accessible.  As with the Laparoscopic technique, the gall bladder is carefully removed from the liver bed. 

 Advantages of Lapaoscopic Cholecystectomy

  1. Smaller cuts therefore less pain and discomfort after surgery’
  2. Smaller/minimal scars
  3. Less time in hospital
  4. Shorter recovery period – days rather than weeks
  5. Early return to normal physical activities and work
     

Risks of Laparoscopic Cholecystectomy

 

Risks of General Anaesthetic

 Specific

  • Injury to major vessels - excessive bleeding
  • Infection
  • Injury to nearby structures such as the intestine
  • Bile leakage causing abdominal irritation
  • Injury to bile duct or cystic duct - may require a stent placement or  another operation
  • Gas embolism – a rare but potentially serious complication; occurs when carbon dioxide gas gets into the vessels
  • DVT/PE

Prior to the procedure, it is important that you inform the doctor/hospital of any health problems, allergies or reactions to drugs that you are aware of.  You will be required to fast from midnight.  You may be advised not to take aspirin, medicines containing aspirin, garlic, medicine for the heart that thins the blood, large amounts of vitamins or anti-imflammatory medication for at least 10 days prior to the procedure as they may increase the risk of bleeding during the operation.

After the procedure you will be taken to the recovery room and subsequently transferred to the ward.  Pain relief will be offered if necessary.  Sometimes nausea and vomiting can be a problem and these will be controlled by medications from the nursing staff.  Sometimes a drainage tube is left inside that will come out of the side of your abdomen.  Drainage tubes are usually removed within the first 24 to 48 hours.  You will be encouraged to mobilise as soon as possible after the operation.


Discharge

Most patients are fit for discharge within one of two days.  Some mild pain and soreness may be present for about a week and you are advised to take things easy during this time.  Regular light duties and activities may be resumed within one week.A follow up appointment will be made with Dr Warrier in a week after the procedure.  However, if you have any unwanted side effects such as fever (more than 37.8ºC), chills, very red or discharging wound, increasing pain or any serious concerns, please contact Dr Warrier for advice.

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Dr Warrier, Surgery, Laparoscopy, Colonoscopy,  Endoscopy   Dr Warrier, Surgery, Laparoscopy, Colonoscopy,  Endoscopy