Gall bladder Surgery (Cholecystectomy)

Gall bladder Surgery (Cholecystectomy)

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Overview

The gallbladder is a pear-shaped organ, and it stores bile (a fluid made by the liver that helps digest fat). The gallbladder releases bile through a common bile duct tube, and these ducts connect the gallbladder and liver to the small intestine. Overtime, you may experience some health concerns related to the gallbladder that may require conservative or surgical interventions.

What is cholecystectomy?

A cholecystectomy is the surgical removal of your gallbladder. There are two types of gall bladder surgery:

  • Open Surgery
  • Laparoscopic Surgery

Who needs a cholecystectomy?

A cholecystectomy is considered for a patient who suffers from the below-mentioned problems:

  • Gallstones
  • Swelling or infected gallbladder (cholecystitis)
  • Gallbladder cancer

Gallbladder problems may lead to pain which may be of the following types:

  • Generally, on the middle or right side of your upper belly
  • Pain which is constant or may get worse after a heavy meal
  • Sometimes feel more like fullness than pain
  • Sometimes in the back and the tip of the right shoulder blade

Other symptoms may include:

  • Nausea
  • Vomiting
  • Fever and chills

What is the risk associated with cholecystectomy?

Some of the possible complications of a cholecystectomy may include:

  • Infection
  • Bleeding
  • Injury to the bile duct, which carries bile from the gallbladder to the small intestine
  • Injury to liver
  • Feeling of numbness or scar presence at the site of the incision
  • A bulging of the tissue or organ (a hernia) at the site of the incision

How to prepare for cholecystectomy?

Once you present with symptoms, your doctor will take your medical history and do a physical exam to assess your health status. Various health parameters like the age and weight of the patient, any past surgeries, allergies to any medicines, personal history, and family history of heart attacks will be noted. The doctor may advise some tests, such as blood investigations, before the surgery. If you have diabetes, you should ask your doctor; if you can continue taking insulin before the procedure. You will be advised to avoid alcohol and smoking, restrict drinking or eating anything after midnight or one night before the surgery. Tell your gastroenterologist if you are on any blood-thinning medicines like aspirin or other medications which affect blood clotting. You may be advised to stop taking these medicines before the procedure. Please, follow all the instructions your doctor gives you to get ready.

What happens during a cholecystectomy?

The type of cholecystectomy done may vary depending on your condition. You will be taken to the operation room, and an intravenous (IV) line will be put in your arm or hand, and the anesthesia will be started. Your vitals like heart rate, blood pressure, breathing, and blood oxygen level will be checked during the surgery.

  • Open cholecystectomy: In this surgical method, one incision of about 4-6 inches long is made on the upper right-hand side of the abdomen. The surgeon locates the gallbladder and takes it out through the incision. In some patients, one or more drains may be put into the incision, which allows the drainage of fluids or pus.
  • Laparoscopic cholecystectomy: This is a minimally invasive surgery where 3-4 tiny incisions are made. The surgeon uses a long, thin tube called a laparoscope, which has a small camera and surgical tools. The tube is put in through the tiny incisions. The surgeon performs the surgery while looking at a TV screen, and the gallbladder is removed through one of the incisions.

After completion of the procedure, the gallbladder is sent to a lab for testing. The incisions will be closed with surgical staples or stitches. A sterile dressing or adhesive strips will be used to cover the wounds.

What happens after a cholecystectomy?

  • In the hospital: Post-surgery, you will be shifted to the observation room and will be under observation. Once your pulse, blood pressure, and breathing are stable, and you are awake and alert, you will be shifted to the hospital room.
    • Laparoscopic cholecystectomy: Patients can often go home the same day post-surgery, though sometimes a one-night stay in the hospital is needed. In general, once you can eat and drink without pain and can walk without any assistance, you can expect to go home. Usually, it takes about one week to recover fully.
    • Open cholecystectomy: The hospital stay after open surgery is around 2-3 days. You will be getting the pain medicine, or you may get it through your IV (intravenous) line. You may have a thin tube that goes through the nose into your stomach. This is to remove the air that you swallow. When your bowel starts working, usually, the tube will be taken out. However, you won’t be able to drink or eat until the tube is removed. Once at home, it may take four to six weeks to recover fully.
  • At home: Once you are discharged, please follow the below-mentioned guidelines:
    • Rest: Allow yourself to have extra rest after the surgery.
    • Medicine: Take all the medications on time as suggested by the doctor. This will help you to recover well.
    • Sponge bath: Till all your sutures are healed, take a sponge bath. Once your doctor approves a regular bath, you may go for it.
    • Exercise: Regularly do exercises taught to you by your physiotherapist but avoid strenuous activity. In case you experience pain or difficulty doing it, get in touch with a physiotherapist.

When should you consult a doctor?

If you experience any of the below-mentioned health concerns, please consult your doctor:

  • Having fever or chills
  • Swelling, redness, swelling, bleeding, or other drainage from the incision site
  • Excessive pain around the incision site
  • Noticing the yellowing of the skin or the whites of your eyes (jaundice)
  • Abdominal pain, swelling, or cramping
  • No bowel movement for three days
  • Having pain behind your breastbone

What is the outcome of Cholecystectomy?

A cholecystectomy helps in relieving the pain and discomfort of gallstones. Conservative treatments methods like dietary modifications generally can't stop the recurrence of the gallstones. In most cases, undergoing cholecystectomy will prevent gallstones from coming back. Most patients won't experience digestive problems after the surgery as the gallbladder isn't essential to healthy digestion. Although, some patients may experience occasional loose stool after the surgery, which generally resolves over time. If you face some issues with your bowel habits, please discuss them with your doctor, and he will help you deal with them.

Tips to take care of gallbladder

By making some lifestyle modifications, you can lower the risk of gallbladder problems.

  • Try to maintain the ideal body weight.
  • Keep yourself involved in physical activities like yoga, gym, etc., and limit the time you spend sitting or lying down.
  • Follow a healthy diet plan which includes plenty of green vegetables, fruits, and whole grains and limits or avoids processed and red meats, sugary drinks, and highly processed foods.
  • Limit alcohol consumption as much as possible.

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