What is gall bladder and its function?
Gall bladder is small organ that collects and stores a fluid from liver called bile. Bile helps in the digestion of food especially fats. Single or multiple stones may develop in the gall bladder and can cause several symptoms including pain and indigestion.
Q. What are symptoms of gall stones?
Patient with gall stone may present with following symptoms
- Pain in right side or upper abdomen with radiation to back and right shoulder.
- Nausea and vomiting especially after fatty meal
- Fever
- Jaundice
Laparoscopic Gallbladder Surgery (Lap. Cholecystectomy)
When gall bladder is not functioning correctly and causes discomfort and pain removal of gall bladder may be advised by your doctor. Previously gall bladder surgery was performed by open technique by a big incision but currently gall bladder surgery is performed laparoscopically by making three to four small keyhole incisions. Air is insufflated in the abdomen and a camera (laparoscope) is introduced into the abdomen and through another keyhole surgery is performed.
Q. Who should get gall bladder surgery (Laparoscopic removal of gallbladder)?
Answer. All patients who have gall stones and symptoms like pain upper abdomen and indigestion should seek consultation for removal of gall bladder surgery. Diabetic patients having gall stones should go for gall bladder surgery even there are no apparent symptoms. Gall stones can be silent for years but can cause serious complication like jaundice, swelling of gall bladder (cholecystitis) and swelling of Pancreases (Pancreatitis) a serious life-threatening condition. Chronic gallbladder infection can also cause cancer of the gallbladder.
Q. Will Gall bladder removal affects digestion and quality of life?
Answer. After gall bladder removal, liver juice (bile) continues to flows from the liver into the small intestine where it helps in digestion of fats. Although bile storage function of gall bladder is lost but the system for fat digestion remains intact. So in majority of the patient there is no impact on quality of health and fat digestion.
Q. Are there any complications of gall bladder surgery?
Answer. Laparoscopic removal of gallbladder (cholecystectomy) is quite safe operation and complications are rare. However less than one percent may encounter following complication following laparoscopic cholecystectomy.
- Conversion to open procedure
- Bleeding
- Injury to bile duct and leakage of bile
- Injury to intestine
- Infection
- Complications of general anesthesia
- Missed stone in the common bile duct
Most of the complications are manageable without surgery but few may require further procedure to manage these complications like placement of drain, ERCP and rarely re-exploration to manage the complication.
Q. What will be the preparation for surgery?
A. You will have to get few blood test and ultrasound abdomen before surgery. In the morning take routine medication and start complete fasting (NPO) six hours before scheduled time of surgery and before leaving for hospital take your labs reports and medical record with you.
Q. What to expect next before and after surgery?
A. Patient is called for admission 2-3 hours before surgery after completing the registration process detailed history and physical examination is recorded by the surgery doctor in the emergency room and then patient is shifted to pre-operative room for anesthesia evaluation, consent and preparation for surgery.
Surgery usually takes an hour then overnight patient is kept in the post-operative ward for monitoring and pain management. Liquids are allowed after 3-4 hours and semi solids next morning. Most patient goes home next morning but few requires hospital stay of one day more for pain management or for other medical reasons.
Patients are fully mobilized within twenty-four hours and return to their normal activities within 8 to 10 days.
Patients are followed up at one week and most patients resume their normal diet within one week. No long-term dietary precautions are required.
Q. When to call your surgeon after Laparoscopic surgery for gall bladder?
- Fever more than 101F
- Abdominal pain and distension
- Yellowness of skin and eyes
- Feeling sick with nausea and vomiting
- Difficulty in breathing
Author: Professor Farooq Ahmad Rana MRCS, FCPS, FRCS, FACS USA