Laparoscopic Gallbladder

Surgery Overview

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Laparoscopic gallbladder surgery (cholecystectomy) removes the gallbladder and gallstones through several small cuts (incisions) in the abdomen. The surgeon inflates your abdomen with air or carbon dioxide in order to see clearly.

The surgeon inserts a lighted scope attached to a video camera (laparoscope) into one incision near the belly button. The surgeon then uses a video monitor as a guide while inserting surgical instruments into the other incisions to remove your gallbladder.

Before the surgeon removes the gallbladder, you may have a special X-ray procedure called intraoperative cholangiography, which shows the anatomy of the bile ducts.

You will need general anesthesia for this surgery, which usually lasts 2 hours or less.

After surgery, bile flows from the liver (where it is made) through the common bile duct and into the small intestine. Because the gallbladder has been removed, the body can no longer store bile between meals. In most people, this has little or no effect on digestion.

In 5 to 10 out of 100 laparoscopic gallbladder surgeries, the surgeon needs to switch to an open surgical method that requires a larger incision. Examples of problems that can require open rather than laparoscopic surgery include unexpected inflammation, scar tissue, injury, and bleeding.

What to Expect After Surgery?

You may have gallbladder surgery as an outpatient, or you may stay 1 or 2 days in the hospital.

Most people can return to their normal activities in 7 to 10 days. People who have laparoscopic gallbladder surgery are sore for about a week. But in 2 to 3 weeks they have much less discomfort than people who have open surgery. No special diets or other precautions are needed after surgery.

Why It Is Done

Laparoscopic gallbladder surgery is the best method of treating gallstones that cause symptoms unless there is a reason that the surgery should not be done.

Laparoscopic surgery is used most commonly when no factors are present that may complicate the surgery.

How Well It Works

Laparoscopic gallbladder surgery is safe and effective. Surgery gets rid of gallstones located in the gallbladder. It does not remove stones in the common bile duct. Gallstones can form in the common bile duct years after the gallbladder is removed, although this is rare.

Risks

The overall risk of laparoscopic gallbladder surgery is very low. The most serious possible complications include:

  • Infection of an incision.
  • Internal bleeding.
  • Injury to the common bile duct.
  • Injury to the small intestine by one of the instruments used during surgery.
  • Risks of general anesthesia.

Other uncommon complications may include:

  • Gallstones that remain in the abdominal cavity.
  • Bile that leaks into the abdominal cavity.
  • Injury to abdominal blood vessels, such as the major blood vessel carrying blood from the heart to the liver (hepatic artery). This is rare.
  • A gallstone being pushed into the common bile duct.
  • The liver being cut.

More surgery may be needed to repair these complications.

After gallbladder surgery, some people have ongoing abdominal symptoms, such as pain, bloating, gas, and diarrhea (post-cholecystectomy syndrome).

What to Think About

Recovery is much faster and less painful after laparoscopic surgery than after open surgery.

  • The hospital stay after laparoscopic surgery is shorter than after open surgery. People generally go home the same day or the next day, compared with 2 to 4 days or longer for open surgery.
  • Recovery is faster after laparoscopic surgery.
  • You will spend less time away from work and other activities after laparoscopic surgery (about 7 to 10 days compared with 4 to 6 weeks).

our SPECIALISTS

Can I Function Without A Gallbladder

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Yes you can. The bile will still be produced in the liver and find its way to the small intestine. It will continue to break down your dietary fats and to remove toxins from the liver. What is different is that the bile will no longer be as concentrated (the gallbladder removes 90% of the water from the bile) and its function as a regulator will be gone. Some people have no problem with this at all; others have problems with getting the right amount of bile at the right time, either too much or too little.

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Is Gallbladder Surgery Effective

What is meant by effective? Will you never have another gallbladder attack? I mean, how could you if you have no gallbladder, right? Will you never suffer from indigestion again? Will your gas and bloating disappear? Will the constipation go away? Will diarrhea resolve?

The answer to all of the above is “sometimes”. Actual attacks are rare, but other forms of pain and discomfort are possible and new symptoms can also develop. Read on…

Let’s look at gallbladder attacks. Gallstones can also be found in the liver and the bile ducts leading to the gallbladder. The attack is often (but not always) caused by a stone blocking a duct. And yes, this can still happen. As seen by research above, stones are formed partly due to what we eat. If we take the gallbladder out and continue to eat the same lithogenic forming diet that we did before, why should stones not form? They will. You may never know it. You may be asymptomatic for the rest of your life. Or, you may get a stone stuck in a bile duct. This is one of the reasons for the most frequently asked question on this site: “I had my gallbladder removed months (or years) ago. Why do I still have pain?” (See testimonials for examples.) Removing the gallbladder does not always address the problem in the body that is causing these or other symptoms listed above. It has probably taken years for your body to form these stones. Your fat digestion has been impaired for a long time. In order to break down and digest fats, your body must produce bile, which is done in the liver. To address the root of the problem you must study and reflect on the causes of gallbladder disease. There could be an underlying thyroid problem which research connects with both gallstones and a low-functioning gallbladder. Food allergies may also be a big part of it and stress as well.

Another thing to keep in mind is that you could have another gallbladder disease that has not yet been diagnosed. For example, if an ultrasound is done and gallstones found, a cholecystectomy or gallbladder removal will be recommended without doing any further exploration. This is because the most obvious and easily diagnosed cause of gallbladder attacks is gallstones or cholelithiasis. And ultrasound is quick and non-invasive. However, if your gallbladder is ejecting bile below 33%-40% which is considered normal range, you would be diagnosed with a low-functioning gallbladder or biliary dyskinesia. This can only be determined with a HIDA scan which is an invasive procedure using radioactive dye. Symptoms of biliary dyskinesia are not always resolved with cholecystectomy either for various known and unknown reasons. One reason is that the problem could be with the Sphincter of Oddi rather than the gallbladder itself.

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