One of the most common surgical procedures performed in the United States is a Cholecystectomy, the gallbladder removal medical term.
Historically, this surgery was performed through a gallbladder removal incision that was 4-6” long but today, unless there are extenuating circumstances the majority are performed laparoscopically through a small incision near the belly button. Due to the technique used, it is most often referred to as laparoscopic gallbladder removal.
What Is A Gallbladder And What Does It Do?
The gallbladder, which resembles the shape of a pear, is located just below the liver on the right-hand side.
Its primary function is to store and concentrate a digestive fluid called bile that is produced by the liver. The gallbladder releases this fluid into the digestive system through narrow tubular channels called bile ducts where it breaks down and absorbs fat from food. Usually, patients do not experience any digestive disturbances due to the removal of their gallbladder.
How Do Gallbladder Problems Arise?
Gallstones form from cholesterol and bile and become small hard deposits that form in the gallbladder. They can be as tiny as a grain of sand or as big as a golf ball and they are generally the reason behind gallbladder problems.
It is not yet known why some individuals are more prone to experience gallstones but women tend to have a higher instance. The risks of developing gallstones increase for women who have had prior pregnancies, are over 40 years old or are overweight. It is not unusual for an individual to have a family history of gallstones. Unfortunately, experts do not know of an exact way to prevent gallstones from occurring.
When gallstones occur, they prevent bile from flowing out of the gallbladder which causes it to swell up. When this happens it can create a fever, vomiting, sharp abdominal pain, and sometimes jaundice can occur – the skin turns yellow.
How Are Gallbladder Problems Found And Treated?
How to diagnose
- The most common test used to identify gallstones is an ultrasound;
- Occasionally, other x-ray tests may be used to investigate gallbladder disease such as a CT scan or a gallbladder radionuclide scan;
- Some of the symptoms may be temporarily managed but gallstones do not go away on their own.
How to treat
- Reducing the intake of fat may help alleviate gallstone symptoms short-term;
- Treatments that are used to dissolve or break up gallstones are not very effective and they will return unless the gallbladder is surgically removed.
What Are The Advantages Of Laparoscopic Gallbladder Removal?
- Laparoscopic gallbladder removal is done through three or four small incisions unlike the five to seven-inch gallbladder removal incisions required for open gallbladder surgery;
- Patients usually experience minimal post-operative pain after a laparoscopic procedure;
- Laparoscopic gallbladder patients normally experience a shorter and easier recovery than patients who undergo open gallbladder surgery;
- Most patients do not require an overnight hospital stay and can return home the same day.
Who Is A Candidate For Laparoscopic Gallbladder Removal?
Patients who have advanced gallbladder disease or prior abdominal surgery may not be suitable candidates for gallbladder surgery. The best way to determine candidacy for gallbladder surgery is through a comprehensive evaluation by a qualified surgeon.
What Preparation Is Needed
Before Having Gallbladder Removal Surgery?
Your doctor will provide you with detailed instructions to prepare you for your gallbladder removal. Surgeons’ requirements may vary as each patient is unique but some of these prerequisites for surgery may include:
- Preoperative testing including blood work, a full health evaluation, and an EKG (depending on your age and health status)
- Your surgeon will instruct you regarding any necessary medications you routinely take
- After you and your surgeon discuss the potential risks and benefits of the operation, you will be asked to sign a written consent form for surgery
- You will need to stop taking certain prescription drugs, anti-inflammatory medications, and herbal supplements such as Vitamin E or St John’s Wort, etc for at least two weeks before surgery
- Your surgeon may ask you to shower the night before with antibiotic soap
- You will need to quit smoking and arrange for any help you may need at home during your recovery
- Because you will be undergoing surgery with general anesthesia you will not be able to eat or drink anything After midnight the night before your surgery
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How Is Laparoscopic Gallbladder Removal Performed?
The steps involved in performing a male or female gallbladder surgery are generally the same but there is a difference in the level of difficulty between genders. It is generally more difficult to remove a man’s gallbladder because men tend to have more anatomic anomalies and a higher degree of fibrosis.
The general steps of gallbladder surgery
- Anesthesia is administered so the patient is asleep during the procedure
- Four small incisions are created in the abdomen
- A laparoscopy is inserted into the abdomen through one of the incisions (a hollow tube-like instrument with an attached video camera)
- Using the real-time video as a guide, the surgeon inserts other surgical tools through the other abdominal incisions to remove the gallbladder
- The surgeon may choose to perform an imaging test before closing the incisions to ensure there are no gallstone obstructions or bile duct issues
- The incisions are closed and patients are moved to a recovery room and observed before either being discharged home or transferred to a hospital room for between one and three days
What If The Gallbladder Cannot Be Removed Laparoscopically?
In a very small number of cases, the surgeon may have to convert a laparoscopic procedure into an open procedure. This can happen if the gallbladder is inflamed, or densely scarred which can occur as a result of previous abdominal surgery. If the surgeon experiences visibility issues or bleeding problems during a laparoscopic procedure they may find it necessary to convert to open gallbladder surgery.
The decision to convert an in-process laparoscopic gallbladder procedure to an open procedure is done to ensure the safety of the patient.
What Can I Expect During Recovery From Gallbladder Removal Surgery?
- Removal of the gallbladder is considered major abdominal surgery and patients will experience some postoperative pain
- Patients may shower the day following their surgery
- Some patients may return home the same day as their surgery and some may be required to stay a night or two. This decision is up to the discretion of the surgeon
- Most patients can return to normal activities within a week including working, driving, etc
- Side effects associated with the use of general anesthesia such as nausea and vomiting
- Patients normally have a follow-up visit with their surgeon after about two weeks
- Patients are encouraged to walk and participate in activities depending on how they feel
Will I have Scarring From The Incisions After Gallbladder Surgery?
The degree of scarring a patient experiences after gallbladder surgery depends on the type of surgery that was performed. The most common form of gallbladder surgery is laparoscopic and requires about four small incisions on the abdomen which would create minimal scarring. Open gallbladder surgery requires a 4 to 6-inch incision which would create a considerable scar.
What Risks And Complications Are Associated
With Laparoscopic Gallbladder Removal?
Any Surgical procedure has associated risks and complications although the risks of a laparoscopic procedure are greatly reduced. Many patients who undergo laparoscopic gallbladder surgery experience no complications and can return to their normal activities very quickly.
Your overall risk factor is affected by your current health condition, the skill of your surgeon, and how well you follow your aftercare instructions.
Complications resulting from laparoscopic gallbladder surgery are rare but may include:
- Bleeding;
- Heart issues;
- Infection;
- Injury to nearby organs;
- Hernias;
- Bile leakage from the liver into the abdomen;
- Blood clots.
If you experience any of these symptoms you should contact your surgeon immediately
- Chronic fever of 101+ F;
- Abdominal swelling that gradually gets worse;
- Yellow skin or eyes;
- Pain that your medication is not relieving;
- Chronic nausea or vomiting;
- Chills;
- Foul-smelling drainage from gallbladder incision sites;
- Chronic cough;
- Severe abdominal pain;
- Ongoing Shortness of breath;
- Bleeding;
- Redness or signs of infection around your incisions.
How Much Does Laparoscopic Gallbladder Removal Cost?
The price of laparoscopic gallbladder removal surgery will vary depending on factors such as your current health, the nature of the surgical procedure, The use of insurance, etc.
The price not only includes the cost of surgery but the expertise of the licensed, trained, and highly experienced IBI Healthcare surgeon or specialist that will be performing this procedure.
Visit Our Pricing Page to learn more about self-pay all-inclusive pricing and available financing options for qualified patients.
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IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.