| Laparoscopic Cholecystectomy |
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GENERAL INFORMATION A cholecystectomy is the removal of the gallbladder which is located under your liver on the right side of your upper abdomen. The reason for removing the gallbladder is usually that it contains stones that cause inflammation and symptoms. COMMON SIGNS AND SYMPTOMS * There is pain over the gallbladder on the right side of the upper abdomen. * Often the pain comes on after a heavy meal. It may come and go or be there all the time. * The pain may shoot to the back and to the tip of the right shoulder blade. * There is loss of appetite or nausea. Sometimes there is vomiting which may have a bitter taste. * There may be fever and chills. * There is tenderness over the gallbladder. This may be mild or it may be very severe. * A fullness may be felt over the gallbladder area. DIAGNOSIS * Can sometimes be made clinically. * An X-ray of the abdomen may show gallstones. * An ultrasound may show the disease of the gallbladder. TREATMENT The best treatment is to remove the gallbladder. Until a few years ago most gallbladders were removed through an abdominal incision. These days most gallbladders can be removed laparoscopically through 3 or more small incisions. The patient has less pain and a faster recovery. It is important to remember that at times it may not be safe to do the operation with a laparoscope and an open cholecystectomy may need to be done. When your doctor converts a laparoscopic cholecystectomy to an open cholecystectomy, this is not considered a complication, this is considered to be good surgical practice. It is important to remember that a cholecystectomy remains a major operation, even when doing it with the laparoscope. This however makes it easier for you. Do not think it is a minor operation. PRE-OPERATIVE PREPARATION * Make sure your doctor knows what medicines you take, especially medicines which may affect blood clotting. * Do not eat or drink anything for 6 hours before the operation. OPERATION * The operation will be done under general anaesthetic. Three or more small incisions will be used through each of which cannulae are inserted. * The operation usually takes one hour or longer. * Usually the whole gallbladder with all the stones it contains is removed. POST OPERATIVE CARE * After the operation you will be taken to a recovery room. When you are stable you will be taken to your regular hospital bed. * Any pain, discomfort, or nausea will be controlled with medication. * If the operation has been completed with a laparoscope you can expect to be discharged a day or two after the operation. COMPLICATIONS 1. Complications are infrequent after a LAPAROSCOPIC CHOLECYSTECTOMY. It is however important for you to remember that it is a major abdominal operation and complications may occur. 2. A bleed or an infection is always possible at the site of the small incisions. 3. Very occasionally a small incisional hernia can develop at a port site. 4. Occasionally a collection of bile develops in the peritoneal cavity. This can delay your recovery. If you are not recovering fairly promptly after the operation your doctor may decide to do an ultrasound. A collection of bile can mostly be drained by needle or catheter without the need for an operation. Very rarely is a further laparoscopic or open operation necessary. 5. There is a 0.5% incidence of damage to the bile ducts in the vicinity of the gallbladder. When this occurs further surgery will be necessary. 6. Also remember that as this is an intra-abdominal operation it is possible for intra-abdominal organs to be injured during the operation. 7. Systemic complications like venous thrombosis and p |