What is cholecystectomy?

 

A cholecystectomy is a surgical procedure to remove the gallbladder (a pear-shaped organ located just below the liver in the upper right abdomen). The gallbladder collects and stores bile (digestive fluid for digesting food that is produced in the liver).

Cholecystectomy is used in people who have pain due to stones that have blocked the bile duct. Cholecystectomy is a common surgery with low risk outcomes. In most cases, patients are discharged from the hospital the same day they have surgery.

In the cholecystectomy operation, four small slits are made in the abdomen and a small camera and special surgical instruments enter the abdomen through this. In this way, the gallbladder is removed while the inside of the abdomen is visible. Internal medicine specialists call this type of cholecystectomy laparoscopic cholecystectomy .

In cases of cholecystectomy, a large incision may be made on the abdomen to remove the gallbladder. This type of cholecystectomy is called open cholecystectomy .

Causes of cholecystectomy

Cholecystectomy surgery is performed in most cases to treat gallstones and their consequences. The internist may recommend this method to the patient for the following reasons:

• The presence of stones in the gallbladder (lithiasis cyst)
• The presence of stones in the bile duct (Choledolithiasis)
• Inflammation of the gallbladder ( cholecystic )
• Inflammation of the pancreas ( pancreatitis ) due to gallstones

Complications of cholecystectomy

Cholecystectomy surgery may have low-risk consequences:

• Bile leakage
• Bleeding
• Blood clots
• heart problems
• infection
• Damage to surrounding structures such as the bile duct, liver, and small intestine
• Pancreatitis
• Pneumonia

The occurrence of these consequences depends on the health of the patient and the reason for this surgery.

Preparation for cholecystectomy

The internist may have recommendations for cholecystectomy surgery for the patient:

• Avoiding eating the night before surgery: The patient may drink water to take his medication, but he must refrain from eating and drinking for at least four hours before surgery.
• Discontinuing the use of certain drugs and supplements: The patient must inform the doctor about the drugs and supplements he is taking. The internist may ask the patient to stop taking some medications and supplements; Because they may increase the risk of bleeding in the patient.

Cholecystectomy surgery is performed with the help of general anesthesia, so the patient will not be conscious during the surgery. Anesthetic drugs enter the patient's body through intravenous injection. After anesthesia, the care team inserts a tube down the patient's throat to help them breathe. The internal surgeon starts cholecystectomy laparoscopically or open surgery.

Laparoscopic cholecystectomy (less invasive cholecystectomy)

During a laparoscopic cholecystectomy , the surgeon makes three small incisions in the patient's abdomen. A tube with a small camera is inserted into the abdomen through these slits. While the doctor observes the inside of the patient's abdomen with the help of a monitor connected to the camera, he removes the gallbladder with the help of a surgical tool that has been inserted into the patient's abdomen through other slits.

If the doctor has concerns about possible gallstones or other problems in the bile duct, he will recommend other imaging tests, such as X-ray imaging or ultrasound. Then the gaps are sutured and the patient is transferred to recovery. Laparoscopic cholecystectomy takes one to two hours.

Laparoscopic cholecystectomy will not be suitable for all patients. In some cases, the doctor starts this type of cholecystectomy and realizes during the surgery that a larger incision is needed due to scar tissue left over from previous surgeries.

Open cholecystectomy (traditional cholecystectomy)

During an open cholecystectomy , the internist makes a 6-inch or 15-centimeter incision below the ribs on the right side of the patient's abdomen. The muscles and tissues are pulled back to make it easier to access the liver and gallbladder, and the surgeon removes the gallbladder.

Care after cholecystectomy

The patient spends some time in recovery for the effects of anesthesia to wear off. Then the patient will be admitted to the hospital for further recovery. The recovery period in cholecystectomy varies depending on the type of surgery:

• Laparoscopic cholecystectomy : In this type of cholecystectomy surgery , the patient usually goes home on the same day of surgery; In some cases, an overnight stay in the hospital may be required. In general, the patient can go home when he is able to eat and drink without pain and walk without assistance. Laparoscopic cholecystectomy requires a one-week interval for full recovery .
• Open cholecystectomy: The patient will usually stay in the hospital for two or three days after the open surgery. At home, the patient needs a period of four to six weeks for full recovery.