Gallbladder Removal


Article Context

  1. Overview
  2. Benefits of gall bladder removal
  3. Procedure
  4. Open vs Laparoscopic Cholecystectomy
  5. Care at Medicover
  6. Frequently Asked Questions

Overview

The surgical procedure to remove gall bladder is called cholecystectomy. Gall bladder is a pear shaped organ that is on the upper right side of the abdomen attached to the underside of the liver.

The liver produces bile (yellow or green digestive fluid) and gallbladder collects and stores bile. Bile helps in the digestion of food, especially fatty food.

Bile thickens about tenfold in the gallbladder, increasing its effectiveness against fats. It does not contain enzymes; instead, it emulsifies fats so that the resulting small fat droplets can be digested by the enzymes in the small intestine.

After eating a meal, gallbladder contracts and delivers bile into the bile duct and then into duodenum (small bowel) to help the digestion of your food.

Symptoms suggesting gallbladder removal are sharp pain in the abdomen, nausea, vomiting, fever, indigestion along with bloating and heartburn, yellowish discoloration of skin and eyes(jaundice).

Indications:

A cholecystectomy is recommended by the doctor if you are suffering from gall bladder conditions which are unresponsive to antibiotics or other treatments.

  • Cholelithiasis: Gallstones in the gallbladder
  • Choledocholithiasis: Gallstones in the bile duct
  • Cholecystitis: Inflammation of gallbladder
  • Large gallbladder polyps
  • Pancreatitis: Inflammation of pancreas due to gallstones
  • Suspected gallbladder cancer
  • Mirizzi syndrome: Obstruction of common hepatic duct caused by compression from impacted stone in the cystic duct of gallbladder.

Benefits of gallbladder removal

  • You should be pain-free and able to eat normally.
  • Surgery will prevent serious complications caused by gallstones.
  • Gallbladder removal treats infection and in most cases stops gallstones from coming back.

Risks of gallbladder removal:

Open gallbladder removal is regarded as a safe procedure. Complications are relatively rare. Every surgical procedure, however, carries some risk. To reduce these risks, your doctor will conduct a thorough physical examination and medical history prior to the procedure.

The following are a few risks during the procedure:

  • Allergic reaction to anaesthesia or other drugs
  • Excessive bleeding
  • Damage to blood vessels
  • Rapid heart rate, heart attack or heart failure.
  • Infection
  • Pancreatitis
  • Blood clots
  • Injury to the bile ducts, small intestine or liver

Procedure

Before the procedure:

  • The surgeon will perform a physical examination to locate the site of pain and inflammation and may order abdominal X-rays, MRI, abdominal ultrasound or endoscopy.
  • Patients should be recommended to stop taking a few medications prior to the procedure.
  • Patients should inform the doctor about any allergy to medicines or anaesthesia.
  • Patients should stop smoking and drinking alcohol at least a week before the surgery.
  • 6-8hours before the surgery, eating or drinking should be stopped. Cleansing of your intestine will be performed with an antiseptic solution before the surgery.

During the procedure

The procedure involves the following steps:

  • A cholecystectomy is performed using general anaesthesia, so you won't be aware during the procedure.
  • Anaesthesia drugs are administered through a vein in the arm. Once the drugs have taken effect, your medical team will insert a tube down your throat to assist you in breathing.
  • You will lie on your back.
  • Surgeon makes an incision of 5-8 inches in the upper abdomen.
  • To reveal your gallbladder, the tissues and muscles are carefully pulled back.
  • Surgeon isolates the gallbladder duct (cystic duct) and artery.
  • The gallbladder is carefully separated from the liver and removed.
  • The surgeon will close the incision with sutures and cover it with dressing.
  • You will be discharged a few days after your surgery.

After the procedure

Following the surgery, your surgeon may recommend that you follow certain measures for a successful outcome:

  • Surgical area should be kept clean and dry.
  • Painkillers such as NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed to manage pain..
  • You should not lift heavy objects initially following surgery.
  • Maintain a healthy diet. It is recommended that you get out of bed and move around as soon as possible.
  • Regularly follow-up with your surgeon.
  • Begin exercising under the supervision of your doctor.
  • You can return to work after approximately 6 weeks.

Open vs Laparoscopic Cholecystectomy:

Gastrointestinal surgeons can remove gallbladder in any one of the following procedures. So let’s understand the differences in the procedure between them.

Open Gallbladder Removal Laparoscopic Gallbladder Removal
Patient is positioned in supine position(Lying on the back). Patient is positioned in reverse trendelenburg position( Lying on the back with an inclination where feet are elevated above the head).
The incision in the abdomen may cause more pain. Less painful.
The depth of the incision is 5-8 inches. Smaller incisions.
Longer hospital stay. Shorter hospitalisation stay.
Delayed return to full activities following procedure. Earlier return to full activity after the procedure.
Scar will be present along the line of incision. Minimal scarring is present.

In some cases, laparoscopic surgery transforms into an open surgery during the operation if the surgeon is not able to view the gall bladder properly or remove it securely.

Care at Medicover Hospitals

Medicover is the best multispeciality hospital providing comprehensive care and treatment to the patients under one roof. We have a team of well renowned gastrointestinal surgeons, laparoscopic surgeons and supporting medical staff who combine their excellent surgical skills and talent with the latest state-of-the-art technology to provide an uncompromised quality of treatment.


Frequently Asked Questions:

The laparoscopic gallbladder removal surgery takes about 30 to 60 mins.

You'll usually have to stay in the hospital for 1 to 3 days after Laparoscopic surgery. Returning to normal activities can take 3 to 4 weeks.

Foods to be avoided are fatty or fried foods, refined sugar, spicy food, caffeinated drinks, alcoholic beverages.

Yes, you can live a perfectly normal life without gallbladder. Your liver will continue to produce enough bile to digest your food, but instead of storing it in your gallbladder, it will drip continuously into your digestive system.

After gallbladder surgery, you can expect to live a completely normal life, but you may experience temporary side effects related to how your digestive system processes fatty foods. Loose stools or diarrhoea, bloating, cramping, and excess gas in response to meals or specific foods are all possible symptoms.

Some people who previously did not have more than one bowel movement per day may experience more frequent bowel movements after gallbladder removal.

Make an effort to walk every day. Try to avoid lifting anything that will cause you to strain. Avoid strenuous activities like biking, jogging, weightlifting, and aerobic exercise until your doctor clears you, usually till 2 months

Doctors usually go for Laparoscopic cholecystectomy which is minimally invasive however some people are not candidates for the procedure. Patients who are obese, have had previous abdominal surgery or who have some other prohibiting factor may require an open surgery.

The most serious risks include bleeding, infection, injury to bile duct and small bowel by one of the tools used during surgery.

You can avoid gallbladder removal by eating a healthy balanced diet of fruits and vegetables rich in fibre and regular exercise of 5 days per week.

References:

  • https://www.americanjournalofsurgery.com/article/S0002-9610%2807%2900846-X/fulltext
  • https://www.healthdirect.gov.au/surgery/open-cholecystectomy
  • https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cholecystectomy