Laparoscopic Cholecystectomy
Cholecystectomy is the surgical removal of the gallbladder, a small organ located under the liver. The gallbladder collects and releases bile to aid in the process of digestion. Although the gallbladder performs a digestive function, it is not necessary for proper body functioning and may be removed if diseased.
Most frequently, a cholecystectomy is performed when gallstones are present and causing the patient distress. The gallbladder may, however, be removed for other reasons, such as to remove cancerous tissue. Laparoscopic cholecystectomy is one of the most common operations performed in the United States.
Diagnosis of Gallbladder Disease
When a doctor suspects the presence of gallstones or other gallbladder disease, diagnostic tests are available to confirm this condition. There are also several tests to confirm the presence of gallstones, including:
- Abdominal ultrasound
- CT scan
- HIDA, or hepatobiliary iminoacetic acid scan
- ERCP, a type of endoscopy in which dye is used to illuminate the biliary tract
- Blood tests to check for infection or pancreatitis
The Laparoscopic Cholecystectomy Procedure
In recent years, cholecystectomies have almost always been performed laparoscopically. This minimally invasive procedure results in less scarring, less pain and a much speedier recovery for the patient than the previously performed open surgery. In a laparoscopic cholecystectomy, in order for the surgeon to remove the gallbladder there are several small incisions made instead of one large one.
This surgery usually facilitates much more rapid healing and permits the patient to return home the same day. Because laparoscopic surgery is a simpler procedure than open abdominal surgery, there is less scarring and a smaller risk of complications developing.
Risks of Laparoscopic Cholecystectomy
Even though laparoscopic removal of the gallbladder is a very safe procedure, there are possible risks with any surgery. These may include:
- Excessive bleeding
- Allergic reaction to anesthesia or medication
- Postsurgical infection
- Deep vein thrombosis
- Injury to adjacent organs
During a laparoscopic cholecystectomy, while unlikely, there are also specific risks of:
- Injury to the bile duct or adjacent organs
- Bile leakage
- Post-cholecystectomy syndrome
Approximately one in seven patients experience post-cholecystectomy syndrome after gall bladder surgery with periods of abdominal or back pain, indigestion, diarrhea, and, in extreme cases, fever and jaundice. Post-cholesystectomy syndrome is thought to result from bile leakage into the stomach or bile duct, or from a stone or stones remaining in the bile duct. Medications may help these problems and, usually, this condition resolves itself in a few months without further surgical intervention.
While there are minimal risks to a laparoscopic cholecystectomy, there are greater risks in allowing gallbladder disease to go untreated. Without treatment, the diseased gallbladder may become infected. The patient may also develop an infection of the bile duct, a fistula, a bowel obstruction or even a malignancy in the area.
Recovery from Laparoscopic Cholecystectomy
Recovery from laparoscopic cholecystectomy is generally smooth and uneventful. In most cases, the patient is able to return to normal activities in a week, and is back to full presurgical wellness within 2 to 3 weeks. The patient is able to resume a normal diet almost immediately after the surgical procedure and should experience no ill effects from the loss of the organ.
