Laparoscopic cholecystecomy (gallbladder removal)
Most gallbladder removal surgery is performed using laparoscopic, keyhole surgery. This is called a laparoscopic cholecystectomy. Under a general anaesthetic, 4 small cuts sized 5 – 10mm are made on the abdomen to allow the insertion of operating ports. Carbon dioxide gas is inserted into the abdominal cavity to create some space for the operation to be performed. The laparoscope (a long, thin telescope with a light and camera lens at the tip) is passed through one of the ports, whilst operating instruments are inserted through the others. The gallbladder is freed off the liver and the duct that drains the gallbladder and the arterial blood supply is clipped and divided. Once the gallbladder is fully freed off the liver it is removed through one of the ports. The gas is released and the skin incisions closed with dissolvable sutures. Most gallbladder operations can now be completed using keyhole surgery; however, occasionally it is not possible to finish the surgery laparoscopically and, in this case, a larger incision is necessary.
Most gallbladder operations are done as a day case, although you will feel sore for a few weeks after the operation and will need to take painkillers for this. It is common to feel pain in the abdomen, as well as pain “referred” to the shoulder tip; the latter of these usually disappears after 48 hours.
What are the risks of laparoscopic cholecytectomy?
Laparoscopic cholecystectomy is a commonly performed, and generally safe, operation. For most people, the benefits in terms of improved symptoms are much greater than the disadvantages. However, all surgery carries an element of risk. Specific complications of laparoscopic cholecystectomy are uncommon, but can include bleeding, infection, leakage of bile from the bile ducts, or accidental damage to other organs in the abdomen (such as the bile duct, bowel, bladder, liver or major blood vessels) requiring further surgery to repair the damage. There is a chance that it will not be feasible to complete your operation laparoscopically and a larger incision will be necessary. In the longer term, some people experience ongoing abdominal symptoms, such as pain, bloating, wind and diarrhoea. These may require further investigation and treatment.
Your surgeon will be able to discuss with you the risks involved in the surgery and answer any questions you might have.