A cholecystectomy, the removal of the gallbladder, is a routine surgical procedure. The gallbladder is a small organ located in the right side of the abdomen, just above the liver, which produces bile to aid in the digestion of fat. The gallbladder sometimes produces gallstones and causes an individual pain, which indicates the removal of the gallbladder. Performed most often as an outpatient procedure, the cholecystectomy carries some risk of complications.
Candidates
Individuals suffering from gallstones are the most likely candidates for removing the gallbladder. Gallstones consist of small masses in the gallbladder comprised of a collection of cholesterol and bile salts. The gallstones may block the passage of bile to the liver and cause intense pain. An ultrasound can confirm the presence of gallstones. The gallstones will not go away by themselves and the only way to remove them is to remove the entire gallbladder. Another reason for removing the gallbladder includes a dysfunctional gallbladder that causes pain and infection.
Laproscopic
Removing the gallbladder laparoscopically carries the lowest risk of postoperative complications and has less pain associated with the procedure. Using a laparoscope, the surgeon creates four small incisions in the abdomen. Placing cameras and surgical instruments in the incisions aids the surgeon in the removal of the gallbladder. A special x-ray, with dye, indicates if any stones remain in the bile duct. If stones remain, the surgeon removes the stones also.
Open Surgery
Some individuals are not able to have the cholecystectomy surgery done laparoscopically. Other times after attempting a laparoscopic procedure, viewing or removing the gallbladder is not possible. During an open procedure, the surgeon makes a large incision, approximately 6 inches in length, in the abdomen to remove the gallbladder. After removing the gallbladder, a special dye injected into the bile duct allows the surgeon to see on a special x-ray if there are any gallstones remaining outside of the gallbladder.
Recovery
An overnight hospital stay is common for a cholecystectomy. A longer stay may be necessary for patients having the open procedure. For laparoscopic surgeries, many patients return home the same day as surgery. Once the patient tolerates fluids, has controlled pain, a normal body temperature and no present postoperative bleeding, discharge from the hospital is allowed. Recovery at home includes controlling pain and monitoring for infection. The advancement of a regular diet and a return to normal daily activities is encouraged.
Complications and Risks
As with any surgical procedure, the positive outcome of the gallbladder removal outweighs the risks of the surgery. Common risks and complications after a cholecystectomy include bleeding, infection in the pancreas, leaking bile and injury to other internal organs during the surgery. Complications from the side effects of anesthesia and other drugs given before, during or after the procedure are possible.
