Cholecystectomy - How a gallbladder removal is performed
- Introduction
- How a gallbladder removal is performed
- Complications of a gallbladder removal
- Recovering from a gallbladder removal
- 'I was having my appendix out and the surgeon spied the gallstones - all 19 of them'
Before having your gallbladder removed (cholecystectomy), you will need to attend a pre-assessment appointment a few days before your operation.
The appointment may involve having some blood tests and a general health check to make sure that you are fit for surgery.
It is also a chance for your surgeon to check that you can have a laparoscopic (keyhole) cholecystectomy. If you have developed complications, such as inflammation or gallstones in the bile duct, open surgery may be required.
You can also use your pre-assessment appointment as an opportunity to discuss any concerns or ask any questions about your operation.
To help you recover from your operation and reduce your risk of complications, it helps if you are as fit as possible beforehand. As soon as you know you are going to have a cholecystectomy, try to stop smoking if you smoke and eat a healthy diet.
Read more about having an operation and general advice about going into hospital.
Laparoscopic (keyhole) surgery
Three to four small cuts are made in your abdomen. One cut (between 2-3cm) will be by the belly button and the others (each about 1cm or less) will be on the right side of your abdomen.
Your abdomen is inflated using carbon dioxide gas. This is harmless and makes it easier for your surgeon to see your internal organs.
A laparoscope (a long, thin telescope with a tiny light and video camera at the end) is inserted through one of the cuts in your abdomen. This allows your surgeon to view the operation on a video monitor.
Your surgeon will then remove your gallbladder using special surgical instruments.
Sometimes an X-ray of the bile duct (operative cholangiogram) will be taken during the operation if there is a risk of gallstones in the bile duct.
If gallstones are found, they can sometimes be removed during keyhole surgery. Your surgeon may have to convert to open surgery if complications occur.
Bile duct stones can also be removed after your operation with a special endoscopy called endoscopic retrograde cholangiopancreatography (ERCP).
After the gallbladder has been removed, the gas in your abdomen will escape through the laparoscope. The cuts in your skin are closed with dissolvable stitches and covered with dressings.
The operation takes 60 to 90 minutes and is usually carried out as a day case, so you can go home that day.
Open cholecystectomy
In some circumstances, a laparoscopic cholecystectomy may not be recommended. This may be because of technical reasons or safety concerns.
Your surgeon will be able to discuss with you the reasons why an open cholecystectomy may be recommended in your case.
During an open cholecystectomy a large incision is made in your abdomen and your gallbladder is removed through it.
The incision is around 10-15cm (4-6 inches) long and is made underneath the ribs. This will result in some scarring.
If complications arise during keyhole surgery, such as bleeding, it may be necessary to convert to open surgery. There is around a 5% chance of this occurring.
Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time. Most people take about six weeks to recover from the effects of an open cholecystectomy.
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