Overview
What is Gallbladder ?
Gallbladder is a pear-shaped organ attached to the undersurface of the liver. Its main function is to collect and store bile (a digestive liquid) produced by the liver. After eating, the gallbladder contracts and releases the bile. The bile is carried via a small tube called the cystic duct and then larger tubes called bile ducts into the small intestine where it helps in the digestion.
What is Laparoscopic Cholecystectomy ?
The surgery to remove the gallbladder is called a cholecystectomy (chol-e-cys-tec-to-my). The gallbladder is removed through a 5 to 8 inch long incision, or cut, in your abdomen. The cut is made just below your ribs on the right side and goes to just below your waist. This is called open cholecystectomy.
A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision.
Gallstones
Gallstones usually form in the gallbladder because of excessive cholesterol in bile. They are a very common medical problem. When they cause pain or other problems, treatment is usually needed. The removal of the gallbladder is one of the most common types of surgery done in this country. In the past, open abdominal surgery was the standard treatment. This procedure required a 3 to 7 day stay in the hospital and a 3 to 7 inch incision and scar on the abdomen.
Laparoscopy
Most females have heard of laparoscopy, also known as "bellybutton" or "Band-Aid" surgery. Gynecologists have long used this technique to tie the Fallopian tubes and to inspect the female reproductive organs. Now the use of laparoscopy has been expanded to include removing a diseased gallbladder. With new video technology, the laparoscope has become a miniature television camera. Powerful magnification is now possible, showing the intestinal organs in great detail.
Laparoscopic Cholecystectomy
A cholecystectomy is the surgical removal of the gallbladder. Using advanced laparoscopic technology, it is now possible to remove the gallbladder through a tiny incision at the navel. The technique is performed as follows. The patient receives general anesthesia. Then a small incision is made at the navel (point A) and a thin tube carrying the video camera is inserted. The surgeon inflates the abdomen with carbon dioxide, a harmless gas, for easier viewing and to provide room for the surgery to be performed. Next, two needle-like instruments are inserted (points B). These instruments serve as tiny hands within the abdomen. They can pick up the gallbladder, move intestines around, and generally assist the surgeon. Finally, several different instruments are inserted (point C) to clip the gallbladder artery and bile duct, and to safely dissect and remove the gallbladder and stones. When the gallbladder is freed, it is then teased out of the tiny navel incision. The entire procedure normally takes 30 to 60 minutes. The three puncture wounds require no stitches and may leave very slight blemishes. The navel incision is barely visible.
What Are the Benefits ?
The main benefit of this procedure is the ease of recovery for the patient. There is no incision pain as occurs with standard abdominal surgery. The patient is up and about the same day. In fact, up to 90% of patients go home the same day. The remainder are usually discharged the next day. And within several days, normal activities can be resumed. So the recovery time is much quicker. Also, there is no scar on the abdomen.
What Are the Complications ?
While the procedure seems very easy for the patient, it is still abdominal surgery. And, even though infrequent, it still carries the same risks as general surgery. Current medical reports indicate that the low complication rate is about the same for this procedure as for standard gallbladder surgery.
These complications may include :
- In about 5 to 10% of cases, the gallbladder cannot be safely removed by laparoscopy. Standard open abdominal surgery is then immediately performed.
- Nausea and vomiting may occur after the surgery.
- Injury to the bile ducts, blood vessels, or intestine can occur, requiring corrective surgery.
- Quite uncommonly, a diagnostic error or oversight may occur.
Are there Other Treatment Options ?
Depending on the size, number, and chemical makeup of gallstones, there is another way to treat the condition. If the stones are small, they may be dissolved with long-term drug therapy lasting 12 to 18 months. A problem with this option is that recurrence of gallstones is frequent, so the problem may not be permanently solved. When symptoms are bad, it is usually unwise to wait because a major complication may occur.
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