Gall bladder is a small organ, located just beneath the liver that aids in fat digestion and concentration of bile. It secretes cholecystokinin in response to fatty food present in the digestive tract and bile which helps in the emulsification of fats. An abnormal functioning of the gall bladder and/or presence of gall stones is one of the primary reasons for gallbladder surgery.
Though uncommon, gallbladder polyps and gallbladder cancer also make up for some of the cases. Most of the cases of gall bladder surgery are uneventful with the body adapting well to the loss of the organ. However, 40% of the cases report some or the other side effects of the surgery. In any case, it is best not to avoid or delay gallbladder surgery as it can lead to serious complications later on and/or even bursting of the organ.
How To Prepare For The Surgery?
Some pre-existing medical conditions and past surgical procedures on the upper abdomen may increase the risk of developing post-surgical complications and therefore surgery is not advised in such cases. It is important to undergo a thorough medical examination to determine your candidacy for the surgery.
After a complete medical evaluation, your surgeon would explain the procedure and the risks associated with the surgery. You would be asked to temporarily stop certain medications a few days before and restrict your intake of food and water a few hours prior to the surgery.
The Surgical Procedure
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There are basically two types of surgical procedures, the open surgery and laparoscopy. Both the procedures are performed under general anaesthesia.
For a minimally invasive surgery, the cannula is inserted into the abdomen through a ½ inch incision in the bellybutton. The cannula is a narrow tube like instrument which facilitates the insertion of laparoscope containing a tiny telescope through it.
The telescope is attached to a special camera which is connected to the video monitor and allows the monitoring of the internal organs. The surgical instruments are inserted through 3-4 other small incisions in the abdomen. The gallbladder is delicately separated and removed through one of the incisions. The incisions are then closed with stitches and surgical tape.
The surgeon may decide to opt for an open surgery anytime during a laparoscopy, if he/she encounters one or more stones in the bile duct or there are other complications such as excessive bleeding. Sometimes, an open surgery becomes necessary due to the patient’s condition, such as obesity, pregnancy, lung diseases, pancreatitis or severe liver problems.
The procedure involves making a single, 5-7 inch long incision in the abdomen, followed by locating and cutting the bile duct and blood vessels that lead to the gallbladder. After this, the gall bladder is removed and the incision is closed with stitches and surgical tape. The entire procedure is complete within an hour.
What Happens After The Surgery?
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It is normal to experience post-operative pain, numbness, nausea and vomiting following the surgery. Some degree of numbness may persist in the operated area even a few months after the surgery. The patients are generally encouraged to resume normal activities as soon as the effects of the anaesthesia wear off.
You may be asked to sit up and walk short distances to avoid the development of blood clots in the limbs, however, strenuous activities should be avoided completely for at least a few weeks after the surgery. Your doctor may also ask you to wear pressure stockings to improve blood circulation and to prevent the formation of blood clots.
At times, the patients are put on incentive spirometer to improve lung function and to prevent pneumonia. The Post-operative stay in the hospital depends on the success of the surgical procedure and the type of surgery performed. On an average, the patients are discharged within 1-4 days after the surgery. Excessive bleeding during or after the surgery, pain and/or fever means a longer stay at the hospital.
What Are The Risks Associated With The Surgery?
Any surgical procedure has its own set of complications and associated risks, such as bleeding in the organ and increased chances of infection. With gall bladder surgery, there is an increased possibility of causing injury to the common bile duct and small or large intestine.
Some patients may also experience inflammation in the pancreas, referred to as pancreatitis, post the surgery. Since the surgery is performed under anaesthesia, the patient may also experience associated complications such as blood clots in the legs or lungs, breathing problems and/or pneumonia, heart problems and even reaction to certain drugs. The appearance of any of the above mentioned complications should be taken seriously and reported immediately to your doctor.
Persistent pain and fever, redness and appearance of pus in the wounds usually indicate an infection and should be reported immediately. Increased abdominal swelling, persistent nausea and vomiting, shortness of breath and persistent cough are an indication of post-operative complications and should be treated on an urgent basis.
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