Cholecystectomy

Introduction

The gall bladder is a small rear-shaped pouch situated under the liver in the upper right part of the abdomen. It stores bile, a liquid produced by the liver and then releases it into one intestine to help digestion.

Gall bladder removal

The gall bladder may need to be removed to treat gall stones. The operation is usually done using key hole surgery which is called laparoscopic cholecystectomy.

Why have gall bladder removal?

Gall stones are small, hard stones which can sometimes develop in the gall bladder. They can result in a blockage of the flow of bile out of the gall bladder symptoms that can include pain, jaundice (yellowed skin) and fever.

The body can function well without a gall bladder and removing it is a common treatment for gall stones that are causing symptoms.

Most gall bladder surgery is performed laparoscopically (“key hole surgery”), but a small number of people used open surgery through a 12-20 cm cut in the abdomen. The consultant will advise which procedure is most suitable in each case.

This leaflet is about the key hole method, laparoscopic cholecystectomy, which the most commonly performed procedure for gall stone.

Alternatives for gall stones

If symptoms are mild, or surgery is not possible for medical reasons, there may be alternatives to having a laparoscopic cholesystectomy to remove gall stones.

Medicines can sometimes be used to dissolve the gall stones. If the gall stones are blocking the bill ducts, may be possible to view them using an endoscope rather than open surgery.

Another type of non-surgical treatment break up the stones using ultrasound waves (lithotripsy).

The operation

A laparoscopic cholecystectomy usually lasts 60-90 minutes and requires a stay in hospital of two nights. In some cases, where adequate support is available at home, it can be a day – case procedure, with no overweight stay. The operation is performed under a general anesthetic, under means that the person is asleep and feels no pain.

To remove the gall bladder specially adopted surgical instruments are inserted through two further small incisions, the incision used in this type of surgery are usually between one and two centimeters long. Under the operation is complete the incision are closed with stitches and the four small wounds are covered with dressings.

Post operative care :

As the anesthetic wear off, there is likely to be some pain. The anesthetist will prescribe pain killers. Suffering from pain can slow down recovery, so it is important to discuss any pain with the doctors or nurses.

There may be a drip in the arm to prevent dehydration. This will be removed once the person is drinking enough.

A physiotherapist may visit to discuss gentle exercises to do at home. These will help speed up recovery.

Deciding to have the operation :

Laparoscopic cholecystectomy is the most commonly performed type of abdominal surgery and is generally a safe operation