Cholecystectomy is a procedure used for removing infected gall bladder. Stones formed in the gall bladder are the most common source of gall bladder infection.
1st in Chennai: Scarless Cholecystectomy
Gall Bladder Stones
The bile stored in the gall bladder contains cholesterol, phospholipids and bile salts in a particular proportion so that the cholesterol in the bile doesn’t easily precipitate into crystals. Due to genetic, nutritional or some other unknown reason, if the vital three ingredients of bile cannot be kept at optimal level, cholesterol crystals form.
The initial cholesterol crystals coalize to form biliary mud in the gall bladder. This is known as sludge. Eventually, the sludge particles coalize to form gall bladder stones. Calcium in the bile salts play a role in the cholesterol crystals forming into stones.
When the stones get infected, or when they try to move out of the gall bladder and, in the process, get stuck somewhere along the way, it starts hurting.
- Infection of the gall bladder is a bad thing as it is in the vicinity of several vital organs. The infection spreading to neighboring organs is a bad news.
- Migration of the gall stone is even worse as the stone may block bile and/or pancreatic duct, throwing the entire digestive system haywire. This can quickly escalate to a life threatening situation
Very rarely, the contents of the gall bladder may coat the inner surface of the gall bladder with a porcelain like coating. This is a dangerous condition as it often turns cancerous. When a porcelain gall bladder is seen in the imaging reports, it is almost always removed quickly.
Polyps are abnormal growth of cells in the surface of the gall bladder. Usually they don’t cause any trouble. But larger polyps can turn into cancer. A gallbladder with large polyp is almost always removed.
Removing the Gallbladder
The current medical belief is that gallbladder is not an essential organ and one can lead a normal life even without it. Besides, it is almost impossible to medically treat most gallbladder diseases. Given that, when a gallbladder starts giving trouble, it is almost always surgically removed. The outlook is to be better safe than sorry.
How is Cholecystectomy Performed
Here are the simple and quick steps involved in conducting a cholecystectomy. In the hands of an experienced surgeon like our Dr. J. S. Rajkumar, it is finished in merely minutes. Of course, it goes without saying that the lesser time a patient spends on the surgical table, the better.
The surgeon accesses the gallbladder through one to four tiny holes made in the abdomen (one tiny hole if it were scarless procedure; 4 tiny holes for a regular laparoscopic procedure).
Isolating the Gallbladder
Through these holes, the surgeon finds the blood vessels feeding the gall bladder and ducts carrying bile into/out-of the gall bladder. These are carefully identified and clipped to prevent leakage.
Detaching the Gallbladder
The liver is slightly lifted up and the gall bladder is carefully detached from the liver using energy devices. Once the errant gall bladder is detached, it is removed through the incision and taken out of the body.
After removing the gall bladder, the tiny holes in the abdomen are stitched. The sutures usually heal with a week. After the surgery, the patient can leave the hospital after a stay of a day or two. They can usually get back to normal life within 5 days.
If the gallbladder stone is not hurting, at LIMA, we prefer not to touch it. A surgery to remove the gall stone is performed only when it starts paining. But when the pain sets in, it usually means that the stone has become infected or started moving out into the bile duct. When that happens, the situation can quickly become life threatening. So, a surgery is performed at the earliest.
Also, when a porcelain gallbladder or a large gallbladder polyp is seen, we strongly recommend that the gallbladder is removed ASAP.
Care After Cholecystectomy
After the recuperation period of 5 to 7 days after a gallbladder surgery, one can go back to normal life. No precautions, other than general healthy eating habits, is necessary.
Video: Laparoscopic Cholecystectomy
You will live very normally without your gallbladder. You can eat and drink everything, like everyone else. You do not need any alteration in diet. It is a myth to think that the gallbladder is necessary for normal life and digestion.
If we remove your stones only, your gallbladder will form stones again within three months. The problem in your body is in your gall bladder, not in your stones. The stones are a result of a sick gallbladder. Therefore to treat you, your gallbladder needs to be removed.
No this is done through keyholes, and is absolutely painless. You will be back to normal activity within two days.
No, you will only have three or four small holes. Indeed, we now do the gallbladders routinely using a scar-less technique. That means we make one small hole within your belly button and remove the gallbladder through that itself. So there is nothing for you to fear.
There are no documented side effects of a gallbladder removal. However sometimes there can be complications during a gallbladder surgery, because the gallbladder is very stuck to the surrounding organs and tissues. But, even in these cases, corrective surgery can be done later and this can be set right.
No, this is best done under general anesthesia where you are completely comfortable. In those who are not fit for the general anesthesia, regional anesthesia like an epidural anesthesia can sometimes be used.
Dr. J. S. Rajkumar
M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)
Dr. S. Akbar
Consultant General and Laparoscopic Surgeon
M.B.B.S., M.S (GENERAL SURGERY), D.MAS, F.MAS.
Dr. Anirudh Rajkumar
Bariatric and Laparoscopic Surgeon
M.B.B.S., Dip.N.B. (GENERAL SURGERY).