LAPAROSCOPIC CHOLECYSTECTOMY
GENERAL INFORMATION
A cholecystectomy is the removal of the gallbladder
which is located under your liver on the right side
of your upper abdomen. The reason for removing the
gallbladder is usually that it contains stones that
cause inflammation and symptoms.
COMMON SIGNS AND SYMPTOMS
- There is pain over the gallbladder on the right
side of the upper abdomen.
- Often the pain comes on after a heavy meal. It may
come and go or be there all the time.
- The pain may shoot to the back and to the tip of
the right shoulder blade.
- There is loss of appetite or nausea. Sometimes
there is vomiting which may have a bitter taste.
- There may be fever and chills.
- There is tenderness over the gallbladder. This may
be mild or it may be very severe.
- A fullness may be felt over the gallbladder area.
DIAGNOSIS
- Can sometimes be made clinically.
- An X-ray of the abdomen may show gallstones.
- An ultrasound may show the disease of the
gallbladder.
TREATMENT
The best treatment is to remove the gallbladder.
Until a few years ago most gallbladders were removed
through an abdominal incision. These days most
gallbladders can be removed laparoscopically through
3 or more small incisions. The patient has less pain
and a faster recovery. It is important to remember
that at times it may not be safe to do the operation
with a laparoscope and an open cholecystectomy may
need to be done. When your doctor converts a
laparoscopic cholecystectomy to an open
cholecystectomy, this is not considered a
complication, this is considered to be good surgical
practice.
It is important to remember that a cholecystectomy
remains a major operation, even when doing it with
the laparoscope. This however makes it easier for
you. Do not think it is a minor operation.
PRE-OPERATIVE PREPARATION
- Make sure your doctor knows what medicines you
take, especially medicines which may affect blood
clotting.
- Do not eat or drink anything for 6 hours before
the operation.
OPERATION
- The operation will be done under general
anaesthetic. Three or more small incisions will be
used through each of which cannulae are inserted.
- The operation usually takes one hour or longer.
- Usually the whole gallbladder with all the stones
it contains is removed.
POST OPERATIVE CARE
- After the operation you will be taken to a
recovery room. When you are stable you will be taken
to your regular hospital bed.
- Any pain, discomfort, or nausea will be controlled
with medication.
- If the operation has been completed with a
laparoscope you can expect to be discharged a day or
two after the operation.
COMPLICATIONS
1. Complications are infrequent after a LAPAROSCOPIC
CHOLECYSTECTOMY. It is however important for you to
remember that it is a major abdominal operation and
complications may occur.
2. A bleed or an infection is always possible at the
site of the small incisions.
3. Very occasionally a small incisional hernia can
develop at a port site.
4. Occasionally a collection of bile develops in the
peritoneal cavity. This can delay your recovery. If
you are not recovering fairly promptly after the
operation your doctor may decide to do an
ultrasound. A collection of bile can mostly be
drained by needle or catheter without the need for
an operation. Very rarely is a further laparoscopic
or open operation necessary.
5. There is a 0.5% incidence of damage to the bile
ducts in the vicinity of the gallbladder. When this
occurs further surgery will be necessary.
6. Also remember that as this is an intra-abdominal
operation it is possible for intra-abdominal organs
to be injured during the operation.
7. Systemic complications like venous thrombosis and
pulmonary embolism are rare, but possible after any
operation or anaesthetic.
pil-laparoscopic cholecystectomy.doc/ver3/20 January
2002 |
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