Cholecystectomy--surgical removal of the gallbladder due to disease or symptomatic stones--is one of the most common surgical procedures performed, particularly on women, the University of Maryland Medical Center reports. Cholecystectomy can be performed laparoscopically, through several very small incisions, or as an open procedure called a laparatomy. Although complications occur infrequently after gallbladder removal, all surgeries carry some risks, and complications can occur. Patients with acute cholecystitis--inflammation of the gallbladder--at the time of surgery are more prone to complications.
Infection
Infection can occur after any surgery. Abdominal surgery carries particular risk of infection that occurs if the bowel, which is close to the gallbladder, is damaged during surgery and leaks fecal material into the abdominal cavity. This is more likely in cases when chronic inflammation of the gallbladder causes the intestines to stick to the gallbladder before surgery, L Marucci, M.D., reports on Inside Surgery. If abscess--a walled-off area of infection--forms, surgery to remove the abscess may be required. Fever, pain, redness or drainage from the incision sites indicate possible infection.
Bleeding
Some bleeding occurs in all surgeries. Heavier bleeding than normal, called hemorrhage, occurred in approximately 2.3 percent of more than 9,000 surgeries performed at the Cluj, Romania Training Center in Laparoscopic Surgery over nine years, lead author S Duca reported in the 2003 issue of HPB: The Official Journal of the International Hepato Pancreato Biliary Association. Hemorrhage may require conversion of laparoscopic surgery to laparatomy, to better identify and repair the bleeding source.
Bile Duct Injury
The most serious complication of gallbladder surgery, bile duct injury occurs in 1 percent or fewer surgeries, according to Duca. Injury to the common bile duct may result from confusion between this duct and the cystic duct in surgeries where acute infection in the gallbladder makes identification of structures difficult. Types of injuries include tears in the duct, leakage of bile into the peritoneal cavity, and development of strictures that narrow the duct that can lead to liver damage, the University of Maryland Medical Center warns. Increasing abdominal pain can indicate bile duct injury and requires immediate medical attention. Surgical repair of damage to the duct may be required.
Gallstone Retention
In about 6 percent of cases, gallstones fall into the abdominal cavity during surgery or are missed during surgery, the University of Maryland Medical Center reports. Retained stones can cause infection, blockages or fistulas, small channels or openings, to form. These may require further surgery.
