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Cholecystectomy

Cholecystectomy is a surgical procedure to remove gallbladder – a pear-shaped organ that sits just below liver on the upper right side of the abdomen. The gallbladder collects and stores bile – a digestive fluid produced in liver.

Cholecystectomy is the surgical removal of the gallbladder. The operation is done to remove the gallbladder due to gallstones causing pain or infection. Cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. Doctors call this laparoscopic cholecystectomy. In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy.

Hospital Stay: Hospital Stay: 2 days
Duration: Duration: 1-2 hrs
Cost Estimate: Cost Estimate: 1350 USD - 3000 USD These are indicative prices in Indian Hospitals

Cholecystectomy is used to treat gallstones and the complications they cause. Cholecystectomy may be recommended in the following conditions:

  • Gallstones in the gallbladder (cholelithiasis)
  • Gallstones in the bile duct (choledocholithiasis)
  • Gallbladder inflammation (cholecystitis)
  • Pancreas inflammation (pancreatitis)

Symptoms

  • Sharp pain in the upper right part of the abdomen that may go to the back, mid abdomen, or right shoulder
  • Low fever
  • Nausea and feeling bloated
  • Jaundice (yellowing of the skin) if stones are blocking the common bile duct.

Preparation

To prepare for cholecystectomy, your surgeon may ask you to:

  • Drink a solution to clean out your intestines. In the days before your procedure you may be given a prescription solution that flushes stool out of your intestines.
  • Eat nothing the night before your surgery. You may drink a sip of water with your medications, but avoid eating and drinking at least four to six hours before your surgery.
  • Stop taking certain medications and supplements. Tell your doctor about all the medications and supplements you take. Continue taking most medications as prescribed. Your doctor may ask you to stop taking certain medications and supplements because they may increase your risk of bleeding.

Surgery:

Cholecystectomy is performed using general anesthesia, so you won’t be aware during the procedure. Anesthesia drugs are given through a vein in your arm. Once the drugs take effect, your health care team will insert a tube down your throat to help you breathe. Your surgeon then performs the cholecystectomy using either a laparoscopic or open procedure.

Single-incision laparoscopic cholecystectomy

Single-incision laparoscopic cholecystectomy is a newer type of keyhole surgery used to remove the gallbladder.

Only one small cut (incision) is made, which means the scar left is barely visible.

Laparoscopic Cholecystectomy:

During laparoscopic cholecystectomy, the surgeon makes four small incisions in your abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon watches a video monitor in the operating room as special surgical tools are inserted through the other incisions in your abdomen and your gallbladder is removed.

Next you’ll undergo an imaging test, such as X-ray or ultrasound, to check your bile duct for abnormalities. If your surgeon finds gallstones or other problems in your bile duct, those may be remedied. Then your incisions are sutured, and you’re taken to a recovery area. Laparoscopic cholecystectomy takes one or two hours.

Laparoscopic cholecystectomy isn’t appropriate for everyone. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or complications.

Open Cholecystectomy

During open cholecystectomy your surgeon makes a 6-inch (15-centimeter) incision in your abdomen below your ribs on your right side. The muscle and tissue are pulled back to reveal your liver and gallbladder. Your surgeon then removes the gallbladder. The incision is sutured, and you’re taken to a recovery area. Open cholecystectomy takes one or two hours.

After surgery:

You’ll be taken to a recovery area as the anesthesia drugs wear off. Then you’ll be taken to a hospital room to continue recovery. Recovery varies depending on your procedure:

  • Laparoscopic cholecystectomy. People are often able to go home the same day as their surgery, though sometimes a one-night stay in the hospital is needed. In general, you can expect to go home once you’re able to eat and drink without pain and are able to walk unaided. It takes about a week to fully recover.
  • Open cholecystectomy. Expect to spend two or three days in the hospital recovering. Once at home, it may take four to six weeks to fully recover.

Prognosis / Outcome:

Cholecystectomy can relieve the pain and discomfort of gallstones. Conservative treatments, such as dietary modifications, usually can’t stop gallstones from recurring. Cholecystectomy is the only way to prevent gallstones.

Some people experience mild diarrhea after cholecystectomy, though this usually goes away with time. Most people won’t experience digestive problems after cholecystectomy. Your gallbladder isn’t essential to healthy digestion.

How quickly you can return to normal activities after cholecystectomy depends on which procedure your surgeon uses and your overall health. People undergoing laparoscopic cholecystectomy may be able to go back to work in a matter of days. Those undergoing open cholecystectomy may need a week or more to recover enough to return to work.

Living without a gallbladder

You can lead a perfectly normal life without a gallbladder. The organ can be useful, but it’s not essential. Your liver will still produce bile to digest food.

However, some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods do trigger symptoms, you may wish to avoid them in the future.

  • The gallbladder is a pear-shaped organ that rests beneath the right side of the liver.
  • Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine.
  • Removal of the gallbladder is not associated with any impairment of digestion in most people.

The gallbladder is a small, pear-shaped pouch in the upper right part of your abdomen (tummy). It stores bile, the digestive fluid produced by the liver that helps to break down fatty foods.
Bile is made from cholesterol, bile salts and waste products. When these substances are out of balance, small, hard stones called gallstones can form. Gallstones often cause no symptoms and in many cases remain undetected.

However, in a small number of cases gallstones can become trapped in a duct (an opening or channel), irritate and inflame the gallbladder, or move out of the gallbladder and into other parts of the body.

This can lead to a range of symptoms, such as:

  • a sudden intense pain in your abdomen
  • feeling and being sick
  • jaundice (yellowing of the skin and the whites of the eyes)

There are several non-surgical ways to break down gallstones, but they are only effective in around less than 1 in 10 cases and are rarely a viable option.

For most people with painful gallstones, it is recommended that their gallbladder is removed.

In open cholecystectomy, the gallbladder is removed through one large incision in your abdomen. This technique is called open surgery. It is a more invasive operation than keyhole surgery. You need to be in hospital for longer and it takes longer to recover.

Open surgery is now usually only used if there are medical reasons why laparoscopic cholecystectomy cannot be safely performed, or if the surgeon decides that it would be safer to switch to open surgery during the procedure (this is known as conversion).

A laparoscopic cholecystectomy is a surgical procedure during which the doctor removes your gallbladder. This procedure uses several small incisions (cuts) instead of one large one.

A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows your doctor to see your gallbladder on a TV screen. Your gallbladder is then removed through another small incision.

The procedure is used when you have stones in your gallbladder.

Your gallbladder stores bile, a fluid made by your liver. Bile helps digest fats in the foods you eat. Gallstones can block the flow of bile in your digestive system. This blockage 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. Gallstones can cause the gallbladder to become infected. A blockage in the common bile duct can cause jaundice (yellowing of your skin or eyes) or irritate the pancreas.

A general anesthetic is given to relax your muscles, prevent pain, and help you fall asleep. Your abdomen is inflated with carbon dioxide, a harmless gas. [A cholangiogram (a special X-ray) is done to check for stones in your common bile duct]. The laparoscope is then inserted through an incision in your navel, so your doctor can look inside.

Other instruments are then inserted through additional small incisions. Your gallbladder is removed through one of these incisions.

The risk of complications is very low, however, potential risks might include:

  • Bleeding
  • Infection
  • Common bile duct injury
  • Minor shoulder pain (from the carbon dioxide gas)
  • Bile leakage
  • Less discomfort than regular surgery
  • Shorter hospital stay, with a quicker recovery time compared to regular surgery
  • Smaller scars than regular surgery

Call your physician if you experience:

  • Increasing pain and redness at an incision site
  • Fever higher than 101°
  • Draining at the incision site that increases or becomes foul smelling

A general anesthetic is given to relax your muscles, prevent pain, and help you fall asleep. A single incision is made below the right side of your rib cage or in the center of the abdomen. Through the incision, your gallbladder and surrounding anatomy can be seen. The gallbladder is detached from its attachments, and the blood supply is tied off and divided. Sometimes a cholangiogram (a special X-ray) is conducted to check for stones in the common bile duct. If there are stones in the common bile duct, they are removed at this time. The skin is closed using surgical clips and sutures.

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