LAPAROSCOPIC CHOLECYSTECTOMY
The gallbladder is situated in the right upper abdomen under the liver and stores bile which is secreted into the intestinal lumen when eating.
Removal of the gallbladder is necessary when it has stones causing symptoms or if it is non functional or has a tumour.It is a very common operation but remains highly technical and can have serious sequelae if not done with due expertise.
SYMPTOMS AND SIGNS
- Cramping severe epigastric pain radiating to back shoulder or scapula tip
- Right upper quadrant pain.May be associated with fatty meals.
- Jaundice or pancreatitis.
TREATMENT
The best is to remove the whole gallbladder with the stones .
This can usually be done with the laparoscope but it may be necessary to make an incision if there has been previous surgery or the gallbladder is too infected or inflamed.
There is no other cost effective way to treat the disease.
DIAGNOSIS
This is best confirmed by sonar.
Abdominal x ray may also show stones.
Nuclear medicine scan may confirm non functional gallbladder with or without stones.
Polyps can also be seen on sonar.
PREOPERATIVE PREPERATION
- Make sure your doctor knows the medication you are taking.
- Stop all medication that may cause bleeding well in advance at your doctors prescription.
- Blood tests will need to be done to determine the screening for other stones during surgery.
- You will not be able to eat for 6 hrs preop.
OPERATION
This is done under full anaesthetic.It will take 40 -60 mins if all goes well.
POSTOP CARE
When you wake up you will have pain at the incision site and you may have pain in your shoulders.This is not severe and will be easily controlled by the pain killers.
Your hospital stay should be 24-36 hrs.and you should be off work for a week.
Exercise should be possible by 2 weeks.
COMPLICATIONS
- Complications if any are very uncommon
- Bleeding or infection may occur after any surgery in the abdomen or the wound
- Specifically bile duct damage may occur or a bile leak which will require further surgery
- Port site hernias may occur
- Venous thrombosis or pulmonary embolism may occur after any operation.
