Surgery for Gallstones-laparoscopic Cholecystectomy (Keyhole removal of the Gallbladder)

What is a laparoscopic cholecystectomy?

Laparoscopic Cholecystectomy is an operation to remove the Gallbladder using a Laparoscopic (Keyhole) surgery. This procedure is most commonly performed for symptomatic Gallstones under General anaesthesia. It involves making 3-4 small holes on the abdomen, the largest of which is 10mm and the others being 5mm. The Laparoscope and instruments are inserted into the abdomen through these ports and the Gallbladder is securely detached from its connections and removed along with the Gallstones. The postoperative recovery is usually quite rapid, with most patients being able to walk within 6 hrs of the surgery and able to eat a semisolid meal in 8-10 hours. After being fully out of the effects of the anaesthetic agents.

Occasionally the same procedure can be done by the SILS (Single-incision Laparoscopic surgery) method. This involves performing the entire operation through the Umbilicus (belly button). The post-operative recovery is the same as with a Multi-port laparoscopy. The biggest advantage of the SILS method is that after complete healing the scar is almost invisible, being hidden in the belly button.

What are the symptoms of Gallbladder Stones?

Gallbladder stones can present in different ways, the common symptoms are of “Indigestion”, right upper abdominal pain which may radiate to the right scapular area, Nausea and occasionally vomiting. Sometimes due to the Gallstones causing complications, the symptoms may be more acute and could be associated with severe pain in the upper abdomen and back, fever and jaundice. The symptoms typically occur after a fatty or heavy meal and tend to be recurrent.

What are the benefits of Laparoscopic surgery?

The benefits of removing the gallbladder by the laparoscopic method are:

• Less pain after surgery
• Shorter hospital stay
• Quicker return to full activity and work
• Less visible abdominal scars

Are there any alternative treatments?

For some conditions, Open cholecystectomy is recommended, where a large incision is made to remove the GallBladder. In very occasional cases, your gallstones may be suitable for treatment with medicines that allow your stones to dissolve-this is typically possible with a single cholesterol stone that is not causing any symptoms. Your doctor will explain this if it applies to you.

Are there risks involved in Laparoscopic Cholecystectomy?

There are risks associated with any surgery. In particular, the risks involved with surgery on the Gallbladder are the following;

1. Bile Leak from the Bile ducts or the Liver.

2. Conversion to open procedure.

3. Injury to the Stomach or Intestine during the procedure.

Quite clearly these risks are very specific to certain clinical situations and your doctor will explain the specific risks of this surgery to you before asking you to sign the consent form. We always insist on the patients clearing all their doubts and understanding the procedure completely before undergoing the surgery.

Will I feel any pain during surgery?

You should expect some discomfort after the operation but the doctor will give you pain relief medications for this. Pain might be there in one or both shoulders. This is caused by irritation to your diaphragm by the carbon dioxide gas used during surgery. You may also feel some discomfort around the incision area and it will be better after taking pain relief. You will gradually reduce the medication after a few days, until you no longer need it.

What happens to my gallbladder after surgery?

The gallbladder will be sent to the pathologist for examination. Your doctor will receive a full report from the pathologist after one week which will be discussed with you during your follow up visit.

How long will I be in hospital?

Most Patients are discharged about 24 hours after the Surgery. Some patients may stay an additional day or two, depending on their recovery.

How long will I be back to my normal activities?

Most people return to work within a week or two of the surgery. Certain specific activity restrictions such as excessive straining and lifting heavy weights will be explained to you before discharge. Similarly, the dietitian will give you instructions on the appropriate post-operative diet. It is best to fully understand the dos and don'ts before discharge to ensure a smooth and early return to normalcy.

When can I bathe or shower?

The wound dressings are removed at the time of discharge in most cases. In most situations, you can have a bath or shower 48hrs after the surgery, unless specifically instructed otherwise.

Can I eat and drink as normal after the surgery?

Removal of the GallBladder does not alter your ability to digest food. However, you may find small and frequent are meals easier to digest in the first few days after your surgery. Increase your intake of foods at your own pace. While you do not need to keep to a specific diet after your gallbladder removal, some people find that they do not tolerate fatty foods in the initial few weeks.