Introduction
A cholecystectomy is surgery to remove the gallbladder, a small pear-shaped organ located beneath the liver. This operation is typically performed when the gallbladder becomes inflamed, develops symptomatic gallstones, or has other conditions that cause pain, infection, or obstruction. The procedure is usually performed laparoscopically. It can also be performed by robotic or open approaches.
Indications
There are several conditions that a cholecystectomy is designed to treat, including:
- Gallstones: The presence of gallstones in the gallbladder can lead to pain, inflammation (cholecystitis), and blockage of the gallbladder outlet.
- Cholecystitis: Inflammation of the gallbladder, which can be acute or chronic.
- Choledocholithiasis: If the gallstones are small and therefore able to travel from the gallbladder down to the common bile duct, the resulting blockage can cause jaundice, bile duct infection (cholangitis) and pancreatitis.
- Gallbladder Polyps: Polyp growths in the gallbladder may require removal if they are above a certain size or found to be growing, which poses a risk of malignancy.
Preoperative Instructions
Before undergoing a cholecystectomy, Dr Moar will perform a medical evaluation, and give you information about the surgery and preoperative instructions. This may include fasting and management of your medications.
Procedure
A laparoscopic cholecystectomy is the most common approach, where several small incisions are made in the abdomen. A laparoscope (a thin, flexible tube with a camera) is inserted through one of the incisions, allowing Dr Moar to visualise the gallbladder and surrounding structures. Surgical instruments are then used to carefully remove the gallbladder.
Alternatively, Dr Moar may perform an open or robotic cholecystectomy in some situations.
Postoperative Instructions
After a cholecystectomy, you will be given specific guidelines for recovery, including:
- Pain Management: Prescribed pain medication to manage postoperative discomfort.
- Wound Care: Instructions on how to care for surgical incisions to prevent infection.
- Physical Activity: Guidance on when and how to resume daily activities, including limitations on heavy lifting and strenuous exercises.
- Diet: Gradual reintroduction of solid foods, with a focus on a low-fat diet to support digestion.
- Follow-up: Information on when to schedule follow-up appointments with Dr Moar to monitor healing.
Risks
Though cholecystectomy is considered very safe, like all surgery it does carry some risks, including infection, bleeding, bile duct injury, anaesthesia complications or conversion from laparoscopic or robotic to open surgery.
Treatment Alternatives
Alternatives to a cholecystectomy may include medications such as antibiotics, endoscopic procedures such as ERCP to remove common bile duct stones, and observation. Sometimes a small plastic drain tube is placed through the skin into the gallbladder (percutaneous cholecystostomy).