What is a Gallbladder & why may I need it removed through surgery?
The most common indication for surgery to remove the gallbladder (cholecystectomy) is symptomatic gallstones. Gallstones are common, and can build up in the gallbladder for a number of reasons.
Gallstones can exist in the gallbladder without causing any symptoms, in which case no treatment is usually necessary. However, gallstones can lead to serious medical problems, including:
- Pain (biliary colic)
- Gallbladder inflammation/infection (cholecystitis)
- Stones in the bile duct / jaundice
- Gallbladder cancer (rare)
When gallstones start to cause persistent problems, removal of the gallbladder (cholecystectomy) can be indicated as an elective procedure. Sometimes for severely unwell patients, this is undertaken as an emergency operation.
What is involved in Gallbladder Surgery?
Surgical removal of the gallbladder is known as a cholecystectomy, and it is usually performed as a laparoscopic (keyhole) operation using four small incisions in the abdomen. Due to the nature of the surgery, it usually involves an overnight stay in hospital. Occasionally the operation cannot be completed using keyhole incisions, and an open operation is required.
Usually a series of X-Rays with contrast dye is performed at the time of cholecystectomy. This is called an Intraoperative Cholangiogram (IOC), and ensures no gallstones have migrated into the main duct which drains the liver (Common Bile Duct). The IOC also acts to confirm the observed anatomy and help prevent injury to the bile duct. In the uncommon circumstance where gallstones are noted in the Common Bile Duct, these additional stones can usually be removed either at the time of surgery or in a subsequent procedure called an ERCP.
The majority of cholecystectomy operations are uncomplicated, and patients make a rapid recovery. However, uncommon complications from laparoscopic cholecystectomy may include:
- Bile leak
- Conversion to open operation
- Common Bile Duct Injury (1:1000 risk)
- Gallstones in the Common Bile Duct
- Anaesthetic complications
Mr MacLeod will take time to explain the nature of the operation, risks, recovery and alternatives to surgery available. You will have the opportunity to ask any questions you may have regarding the recommended treatment plan.