A laparoscopic cholecystectomy is a common keyhole surgical procedure performed to remove the gallbladder due to gallstones causing pain or infection. The gallbladder is small pouch attached to the under-surface of the liver. It acts an extra store-house for a fluid called bile which is produced in the liver. After a fatty meal the gallbladder goes into action by pushing bile into the intestine to help in digesting the fatty meal. Even without a gallbladder the liver still produces bile for digestion. This means that even after laparoscopic cholecystectomy you can live a normal healthy life.
Gallstones are common and don’t always cause symptoms. They can occur when the bile and sediment within the gallbladder pouch thicken and solidifies. Anyone can develop gallstones however they are more common in middle-aged women.
Additional Risk Factors Include:
- Obesity
- High Cholesterol
- Rapid Weight Loss
- Diabetes
- Family History of Gallstones
- Pregnancy
- Some medications
The Symptoms of Gallstones often occur after a fatty/oily meal. This includes:
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Sharp pain in the right upper or middle portion of the abdomen. This may radiate to the right side or the back.
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Indigestion burning discomfort
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Nausea and bloating
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Jaundice (yellowing of the skin) if stones cause blockage of the duct system
If left untreated Gallstone Disease can cause serious complications:
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Inflammation of the Gallbladder – known as Cholecystitis.
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Inflammation – known as pancreatitis
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Blockage of the liver duct piping system
In some cases large gallstones are associated with an increased risk of Gallbladder cancer.
Prior to surgery Dr. Andrew Kiyingi may organise some tests which may include a blood test, ultrasound or even MRI scan to prepare for surgery. As the procedure is performed under general anaesthesia, you will be reviewed by an anaesthetic doctor and will need to fast for a minimum of 6hrs prior. No oral intake or chewing gum. Please advise us before surgery if you
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Have any allergies
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Are pregnant
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Are on blood-thinning or any non-prescription medications.
During the procedure 4 – 5 small incisions (<2cm) will be made on your abdomen. Carbon dioxide gas will be used to expand your abdomen, allowing the organs to be seen. A special narrow camera called a laparoscope, will be inserted through one incision and a video image will be relayed to a tv screen to allow the surgical team to perform the surgery. Further small instruments will be inserted through the other incisions and this will allow Dr. Andrew Kiyingi to remove your gallbladder. Occasionally a special Xray will be performed while you are asleep to allow Dr. Kiyingi to identify any stray gallstones. A small drain may be placed in the wound to drain any residual contaminated fluid. It may stay in for a few days. At the end of the procedure, the incisions are closed with dissolving sutures and covered with a waterproof dressing. The duration of surgery usually varies from 60 to 120mins. The average hospital stay is 1-3 nights. If your surgery is performed as an emergency the risks and the length of admission may vary. The gallbladder is always be sent to the lab for testing at the end of the procedure.
Managing Gallstone disease with surgery is the current standard of care. Not having surgery may worsen your symptoms. However, in some cases, depending on the size and number of gallstones and your other medical conditions, Dr. Andrew Kiyingi may discuss a watch and wait for approach.
Laparoscopic Cholecystectomy is safe; however, complications can still occur as with any surgery. Some Complications include:
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General Anaesthesia Complications particularly relating to maintaining your breathing, heart function, and circulation.
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Damage to surrounding organs
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Leakage of bile leading to infection.
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Blood loss requiring re-operation or blood transfusion
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DVT (blood clot in the deep leg veins)
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Shoulder / Wound Pain – this is temporary for the first few days.
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Hernias from the wounds <1%
Converting the operation from keyhole to Open Surgery in the case of complex gallbladder inflammation. This involves a much bigger incision.
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It is normal to feel tired after surgery.
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You will generally resume a normal diet on the same day and be able to walk around.
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Most patients will have minimal pain. However, pain killers and anti-nausea medication will be available.
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Avoid strenuous exercises and lifting heavy weights for 3-4 weeks
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Please organise a friend or family member to pick you up from the hospital by on the day of discharge.
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Please avoid driving for the first 10 days after surgery
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A clinic review will be organised in 3-4 weeks to assess your recovery and answer any questions. A letter will be sent to your GP.
We Can Help.
If you are experiencing severe or frequent Gallbladder pain attacks, please see your GP for an urgent referral to see Dr. Andrew Kiyingi or go to an emergency department.
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