Gallstone Disease and Laparoscopic Cholecystectomy
WHAT IS LAPAROSCOPIC CHOLECYSTECTOMY?
This the medical term used to describe a keyhole operation for the removal of the gallbladder. This is almost always done for symptomatic gallstone disease. Previously before keyhole or laparoscopic techniques were developed; this operation required a large cut under the right rib cage several inches in length. The laparoscopic or keyhole technique requires four small stab incisions and is now the most common method of removing the gallbladder. The different approaches are shown in the diagram below.
WHAT ARE GALLSTONES?
Gallstones are large crystals which form over long periods of time in the gallbladder. They are usually diagnosed after an ultrasound scan. Many patients with gallstones do not have any problems at all and the scan done for other reasons detects them.
WHAT DOES THE GALLBLADDER DO?
The gall bladder is a pear shaped sac which is attached to the under surface of the liver in the right upper part of the abdomen. Bile ducts (small tubes) carry bile from the liver to the bowel where it helps in the digestion of fatty foods. The gall bladder stores this bile in between meals.
WHAT ARE THE SYMPTOMS OF GALLSTONE DISEASE?
Many patients with gallstone get no symptoms at all. It is therefore important to establish that abdominal pains are likely to be due gallstones prior to surgery.
Gallstones which cause trouble can cause pain which occurs after eating. Most commonly fatty foods such as fish and chips, cheese or pastries are the worst for causing problems.
The pain is usually in the upper part of the tummy and can go round to the back, especially on the right hand side. Inflammation or infection of the gallbladder can also occur. Stones can sometimes move from the gallbladder and cause jaundice (yellow skin) or inflammation of the pancreas gland. This is called pancreatitis and can be a serious and life threatening problem.
Patients with symptoms or one of the complications of gallstones will usually be recommended surgery. This is almost always done with keyhole techniques.
HOW IS IT DONE?
The operation is carried out under general anaesthetic. This means you are completely asleep and unaware of the operation. Usually four small stab incisions are needed to do the operation.
The surgeon will answer any questions you have prior to your surgery.
HOW LONG WILL I BE IN HOSPITAL?
I some patients this operation can be carried out as a day case procedure. This means you go home on the same day and admission to hospital over night is not needed.
If an over night stay is needed then most patients are able to go home the next day. Complex or more difficult case may need to stay longer but these cases are rare.
WHAT ARE THE BENEFITS OF SURGERY?
Clearly the main benefit is getting rid of the symptoms from gallstone disease. Also preventing the complications of gallstones such as pancreatitis and jaundice as mentioned above.
WHAT ARE THE RISKS OF SURGERY?
Although it is a common and straight forward operation there are still risks. Bleeding and infection can occur with all surgery and care is taken at all time to avoid these problems.
Bile leaks or injury to a bile duct near to the area of surgery can occur on rare occasions. These problems may need further intervention with either a telescope test which is swallowed called an ERCP or additional operation.
It is important to stress that these problems are very rare and occur in less than 1% percent of patients.
All operations are done in the interests of safety which means some times the Keyhole or laparoscopic approach is abandoned and a large cut in the tummy is required. This happens only 1-2% of the time.
WILL I NOTICE MY GALLBLADDER HAS BEEN REMOVED?
A part from the relief of your symptoms most patient will not see any change. Digestion and bowel habit is normal and no long term ill effects from have the gallbladder removed.
If you wish to arrange an appointment with Mr. Rob Church contact your GP.
Or Contact Jacque 0782 6559444
Or the Hospital of your choice:
Spire Hospital Little Aston
Nuffield Hospital Wolverhampton
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