Before the 1990s the gallbladder was almost always removed through an incision several inches long gallstone Surgery. Laparoscopic surgery allows the same procedure to be carried out using a number of smaller incisions causing you less discomfort after surgery, which therefore allows a faster return to normal activities. A telescope is inserted through the main incision at the umbilicus (tummy button), which usually gives a very good view of the gallbladder.
An x-ray is sometimes taken during the operation to identify whether any stones have entered the bile duct. If so, they can be removed during the operation or by a separate endoscopic procedure which is performed after recovery from the cholecystectomy. After securing the duct and blood vessel which connects the gallbladder to the bile duct and the main artery to the liver, the gallbladder is freed from the liver. It is then removed from the abdomen through the largest of the incisions.
Alternatives to surgery:
Once formed, gallstones do not disappear spontaneously and treatments to dissolve them are ineffective. Bile duct stones can be treated by an endoscopic procedure, but only surgical removal of the gallbladder is effective for stones in the gallbladder itself. Removal of the gallbladder does not cause any postoperative digestive problems gallstone Surgery.
After cholecystectomy, you can expect to have an IV infusion in place from the theatre. This should be removed once you start drinking. On some occasions, it may be necessary to stay longer than a day case patient and stay overnight in a hospital.
Wound care: The surgical incisions are sometimes closed with metal clips which are easily removed after around 10 days. Alternatively, dissolvable stitches may be used. Small dressings applied over the clips can be replaced if they fall off, or become loose after bathing or showering. It is best not to soak the wounds for too long in the first few days after surgery. If dressings are in place following surgery extra dressings will be supplied on discharge.
Drains: A small plastic tube is sometimes left in the space where the gallbladder was, in order to drain away any fluid from the operation site. Occasionally some bile may leak from small ducts close to the gallbladder and the drain can prevent the accumulation of bile, allowing healing to occur. In most cases, the drain is removed before discharge from the hospital. If you have had the procedure done as a day case, then the drain should be removed within three hours.
Some pain or discomfort is to be expected following any type of surgery. You may be given painkillers while on the unit and some to take home. You may experience some shoulder tip pain, caused by trapped gas from the operation. This will gradually diminish by sucking strong peppermints. You may also find gently walking around helps to relieve the discomfort.
Diet: You will be allowed fluids immediately after surgery and food once you are able to tolerate it.
Nausea/vomiting after surgery: You may feel sickly but this should not stop you from eating and drinking.
Exercise: You will be encouraged to get out of bed soon after surgery and to mobilize as soon as possible.
Driving: Do not drive for 24 – 48 hours following your anesthetic. After this time you may drive when it feels completely comfortable for you to do so and you are able to perform an emergency stop comfortably.
Work: It is advisable to have at least 1- 2 weeks off work. You may return to work when you can perform your job comfortably and safely. The staff can provide you with a doctor’s certificate to cover time off work if required.
Day case patients: If you have had this procedure done on the day surgery unit then you can expect your stay to be at least 4-6 hours. To provide privacy and dignity to all patients, relatives/carers are not allowed in the recovery area. You will need to have a responsible adult with you for the first 24 hours after your surgery.
Further appointments: There is usually no need for you to come back to the hospital after gallbladder surgery unless other procedures are required for stones in the bile duct.
Potential complications: All intra-abdominal operations should be regarded as major surgery and carry some risk. The main specific complications of cholecystectomy are injury to the bile ducts, blood vessels, and bowel immediately adjacent to the gallbladder. These injuries are rare but can require further major procedures for their correction. If the gallbladder is very inflamed, it may be safest to convert the laparoscopic operation to an ‘open’ cholecystectomy through a larger incision Gallstone Surgery. This requires a longer postoperative stay and a slower return to full activity but still gives excellent long term results.