The gallbladder is a small organ underneath the liver that functions in storing bile produced by the liver for digestive purposes. According to the Society of American Gastrointestinal and Endoscopic Surgeons, gallbladder removal, or cholecystectomy, is one of the most common surgeries performed in the United States and the most common reason for a cholecystectomy is gallstones, rock-like masses composed of cholesterol and bile salts that can obstruct flow of bile, which causes pain and inflammation. Most cholecystectomies are performed laparoscopically through small incisions in the abdomen, with a tiny telescope, called a laparoscope, inserted into one incision, and tubes and instruments inserted through the others. A cholecystectomy has risks similar to other operations including bleeding, infection, pneumonia, blood clots and heart problems. There are complications, however, that are unique to a cholecystectomy.
Conversion to Open Cholecystectomy
The University of Maryland Medical Center states that using the laparoscopic method of cholecystectomy is not possible in 5 to 10 percent of cases, and require conversion to an open cholecystectomy in which an extensive incision is needed to expose the intra-abdominal contents. Reasons for conversion include obesity, scar tissue from prior surgery, inability to adequately see organs through the laparoscope and excessive bleeding.
Common Bile Duct Injury
The gallbladder releases bile into a tubular structure, called the common bile duct, which drains bile into the small intestine. According to the American College of Surgeons, the common bile duct is injured in 1 out of 1000 open cholecystectomies and 1 to 5 out of 1000 laparoscopic cholecystectomies. Such an injury may lead to a bile leak into the abdomen and may require another surgery to repair the injury.
Retained Common Bile Duct Stone
The University of Maryland Medical Center states that a gallstone passes into the common bile duct after surgery in 6 percent of cases. Occasionally, the gallstone is of sufficient size to block the common bile duct and prevent bile from flowing into the small intestine. A special type of procedure using a scope through the mouth, called endoscopic retrograde cholangiopancreatography, may be necessary to remove the stone.
Fetal Loss
Pregnancy is a major risk factor for gallstones, and a cholecystectomy may be necessary during pregnancy. According to the American College of Surgeons, cholecystectomy increases the risk of preterm labor, and fetal loss occurs 4 percent of the time during an uncomplicated cholecystectomy, rising to 60 percent when pancreatitis, or inflammation of the pancreas, is present.
Death
Death as a complication from gallbladder surgery is rare in healthy persons, but is as high as 19 percent in ill elderly patients, notes the University of Maryland Medical Center. The risk of death increases with a ruptured gallbladder, gangrene and the presence of other serious medical diseases, such as diabetes. Emergency cholecystectomy also increases the risk of death.
