Gall Bladder Surgery

Gallbladder surgery ( also known as cholecystectomy ), is the surgery done to remove the gallbladder when the gallstones cause symptoms of pain, etc. Gallbladder is the pear shaped organ which stores bile that helps to digest the food. 

If the gallbladder does not function properly, it starts to form hard fragments known as gallstones. These gallstones, if not dissolve, start to cause pain and other symptoms. Around 80 percent of the patients with gallstones need gallbladder surgery. 

Symptoms

The patient needs gallbladder surgery in the following conditions/symptoms -

• Gallbladder attack- sharp, shooting, knife like pain in the lower abdomen that may last for several hours. 
• Gallstones cause blockade of the bile duct
• Sickle cell anemia patients may require gallbladder surgery, as a precaution to avoid symptoms of gallstones
• Cholecystitis- inflamed gallbladder
• Pancreatitis- inflamed pancreas
• Cholangitis- inflamed bile ducts

Diagnosis

The tests done before the gall bladder surgery are- 

• Physical examination 
• Blood tests
• Ultrasound
• MRI HIDA scan
• Endoscopic ultrasonography

Treatment

The patient is given general anesthesia and a tube is inserted in the throat to assist in breathing while the surgery is performed. 

The 2 methods of gallbladder surgery are-

1. Open Gallbladder Surgery- In this method, a large 5-7 inch incision is made in the abdomen region to remove the entire gallbladder. This is done if the patient has a bleeding disorder, is overweight or is in the last trimester of pregnancy.

2. Laparoscopic Gallbladder Surgery- This is also known as keyhole surgery. Small cuts are made in the abdomen, a very thin flexible tube is inserted which has light attached and tiny video camera attached. Then small instruments are inserted to remove the gallbladder. 

Risks

• Infection
• Bleeding
• Swelling
• Bile leakage
• Allergies or problems associated with anesthesia
• Bile duct damage
• Intestines, bowel or blood vessels damage
• Deep vein thrombosis ( blood clots )
• Heart problems
• Pneumonia
• Post cholecystectomy syndrome (PCS) - this happens when gallstones are left in the bile ducts after the surgery or the bile starts leaking in the stomach. Symptoms include- belly pain, heartburn, diarrhea. 

After Procedure

• Patients undergoing open gallbladder surgery must be discharged 2-3 days after the surgery and take 4-6 weeks to recover completely. 
• Incase of laparoscopic gallbladder surgery, the patient is discharged on the same day or next day. 
• The steps of care need to followed at home are-
• Specific bathing instructions, to keep the area clean and dry
• Pain may be felt for a few days at the incision site, painkillers must be taken as prescribed. 
• Strenuous physical activities must be avoided till patient completely recovers
• Post surgery work must be resumed by the patient only when advised by the doctor. 
• Patients must strictly attend the follow up appointments and follow the diet chart as given by the doctor.