Laparoscopic Cholecystectomy

What is the function of the gallbladder and how does gallbladder stone lead to problems?

The gallbladder stores bile, a fluid made by your liver. Bile helps digest fats in the food that you eat. Gallstones which form in the gallbladder due to a multitude of reasons, can block the flow of bile in your digestive system. TH is can also lead to infection. This can cause bloating, nausea, vomiting, and pain in your abdomen, shoulder, back, or chest. Gallstones can also block the ducts that channel the bile from the liver or gallbladder to the intestine, leading to jaundice and pancreatitis. Complications like this are unpredictable and cannot be prevented with any medication.

When is a cholecystectomy (removal of the gallbladder) carried out?

The most common reason for doing this surgery is when one has stones in the gallbladder. Other less common reasons are polyps (tumor), calcification (porcelain GB), infection of the gallbladder, symptomatic adenomyomatosis of the gallbladder etc.

What is laparoscopic cholecystectomy?

The surgery to remove the gallbladder is called a cholecystectomy. During an open cholecystectomy, the cut is made just below your ribs on the right side and is about 3 to 6 inches long depending upon the requirement.

A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a telescope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision, usually 4 incisions, each 1cm or less in length.

Are there any benefits of laparoscopic cholecystectomy compared with open cholecystectomy?

Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are:

  • Less postoperative pain
  • Shorter hospital stay
  • High blood tyriglyceride levels - hypertriglycerdaemia. This is reported to cause 1 to 4 percent of all cases of AP and up to 56 percent of pancreatitis cases during pregnancy
  • Earlier return to normal activity
  • Better cosmetic results
  • Less chances of wound infection
  • Other associated pathology can be picked up

Is there any reason why I wouldn't be able to have a laparoscopic cholecystectomy?

  • Patient is not fit for anesthesia
  • Patient has cardiac problems in the for poor ejection fraction
  • Severe obstructive airway disease
  • Coagulopathy
  • Complicated anatomy
  • Extensive adhesions
  • Bleeding during surgery
  • Any situation during surgery which precludes safe surgery

What are the complications of laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is a relatively safe surgery, however as with any other operation complications are known to occur.

  • Bleeding
  • Bowel injury
  • Bile duct injury
  • Bile leak & bile collections
  • Abscess
  • Sepsis and septicemia
  • Pancreatitis
  • Cholangitis
  • Port site infections
  • Hernias
  • Retained or missed CBD stones or cystic duct stones
  • Rarely even death (in less than 0.1%)

This list however is not exhaustive and patients may also developed complication not form surgery per se but from their associated medical conditions like diabetes, high blood pressure, heart disease etc

Patient may also need additional intervention or even repeat surgery to tackle these complications.

When to Call Your Doctor

Be sure to call your physician or surgeon if you develop any of the following:

  • Persistent fever over 101 degrees F (39 C)
  • Bleeding
  • Increasing abdominal swelling
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • Chills
laparoscopic cholecystectomy