Gall bladder surgery, also known as cholecystectomy, is a procedure that involves excision and removal of the gallbladder. Laparoscopic cholecystectomy involves the use of a laparoscope, a lighted tube that enables a surgeon to look inside the patient's abdomen. This procedure involves only small incisions on the abdomen to insert instruments. Open cholecystectomy is a procedure that involves a large cut in the right upper abdomen to remove the gallbladder. Under normal circumstances, laparoscopic cholecystectomy is performed rather than open cholecystectomy. Both procedures can have complications.
Bleeding
Bleeding during the surgical procedure is one of the most common complications of cholecystectomy. This is usually due to blood vessel injury. This problem, if left unrecognized and untreated, can cause possible mortality due to hypovolemic shock, a condition in which there is severe depletion of blood volume causing decreased distribution of blood and oxygen supply to the other organs. Ligation of the bleeding vessel can stop the bleeding during surgery. Blood transfusion during and after the procedure can correct the blood volume deficit brought about by the bleeding.
Common Bile Duct Injury
Common bile duct injury occurs when there is an accidental cut to the gallbladder during surgery. Its incidence rate is 0.1 to 0.2 percent in open cholecystectomy and 0.4 to 0.6 percent in laparoscopic cholecystectomy, according to the Mt. Sinai Surgical website. If left unrepaired, it can cause bile leakage, which is leaking of the bile juice into the abdominal cavity, or obstruction of the bile ducts. Prompt repair of the injury is necessary during the surgery to avoid any complications. However, if bile leakage is noted post-operatively, another surgery may be necessary to correct the problem.
Subhepatic Abscess
Subhepatic abscess, or a pus-filled mass-like formation immediately beneath the liver, is a consequence of the spillage of contents from the gallbladder into the abdominal cavity. This problem can take months or even years to form after the surgery. Proper surgical procedure and prompt removal of the stones is necessary to avoid perforating the gallbladder and spilling its contents into the abdominal cavity.
References
- MedlinePlus: Gallbladder Removal -- open
- SAGES Guidelines for the Clinical Application of Laparoscopic Biliary Tract Surgery: Indications
- "British Journal of Surgery"; Open cholecystectomy in the laparoscopic era; Jenkins P.J. et al.; 2007
- "HPB"; Laparoscopic cholecystectomy: incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations; Duca, S et al.; 2003
- Mount Sinai Surgical Residency Page: Bile Duct Injuries Following Laparoscopic Cholecystectomy; Sarpel, U.; July 2004
