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Patients recover very quickly from this abdominal operation and it is rare to suffer serious side-effects. Cholecystectomy produces a number of minor post-operative complications so it is important to understand these as well as the rare potential for more critical complications.

About Gall Bladder Removal

The gall bladder is situated beneath the liver and holds bile in a small sac, bile which the liver secretes. Bile is releases in the gut to assist in the digestion of food fats whenever we have a meal. Gall stones can develop within the gallbladder and can be of various types and sizes. It is common for people in the middle of life or older to have gallstones which are not symptomatic and do not require surgery.

Sometimes the stones can lead to pain or inflammation with the gall bladder. In some patients stones may escape from the gall bladder and get into the main bile duct (the main tube connecting the liver to the gut) where they can cause an obstruction leading to jaundice (yellow pigmentation of the skin). In these cases it may be necessary to perform a cholecystectomy (surgical removal of the gall bladder).

Is Gall Bladder Surgery Harmful?

Many people live a completely normal existence without their gall bladders as it is only an organ to store bile. Cholecystectomy should cause no serious long-term side effects.

The way Gall Bladder Operation is Performed

Surgeons can use the more traditional open surgical technique or the more modern laparoscopic or keyhole surgery which is the overwhelmingly more common method but about one in twenty or five percent of operations are through an open incision. This is because the surgeon decides it is safer and the most common reasons for open surgery are because the gall bladder is very inflamed or if it has a lot of adhesions sticking it down to nearby organs.

Although surgeons mostly intend to perform the gall bladder removal laparoscopically, patients need to understand that during the operation the decision may be made to convert to an open operation on clinical grounds.

Keyhole Surgery for Gall Bladder Removal

The surgeon will make four small cuts so that he or she can insert the instruments they will use into the abdominal cavity. The main instrument is a laparoscope, a flexible device which has a small video camera and a bright light attached, allowing a clear view of the inside of the abdomen. This allows surgeons to view the abdominal contents on a television screen, find the gallbladder and guide the operation procedure.

The surgeon needs a good view of the abdomen so carbon dioxide is passed into the cavity to increase the room for manoeuvre. An incision below the umbilicus (tummy button) is used to insert the telescope and further instruments are introduced through three smaller cuts below the right ribs. The umbilical incision is used to withdraw the gallbladder and gallstones.

Open Cholecystectomy

Removal of the gallbladder via open operation sometimes cannot be performed, meaning that an open operation will have to be done. The incision is about four to six inches long below the right cage to allow the surgeon to locate the gall bladder. Then the organ can be removed and a drain inserted to drain off any excess fluid from the abdomen.

What about the Anaesthetic?

The anaesthetic is usually started by giving an injection into the hand or arm. The operation usually takes about one hour and the surgeon will often inject some long-lasting anaesthetic into the incision sites to try and make the patient as comfortable as possible afterwards.

In addition some surgeons insert a long-acting painkiller in the form of a suppository into the back passage when the patient is asleep. Patients are advised clearly about having no food for about 6 hours before the operation and nothing to drink for about 2 to 3 hours beforehand. After the operation patients can get up as soon as they feel able with a nurse making sure they can manage when they first get up.