Cholecystectomy

Transcript

Removal of the gallbladder, called cholecystectomy, is usually performed when there is evidence of gallstones or inflammation of the gallbladder.

Symptoms of gallbladder disease usually consisting of intermittent right upper abdominal pain most commonly occur when gallstones temporarily block one of two ducts that carry bile from the gallbladder to the intestine.

If the stones do not pass, the gallbladder may become swollen, inflamed, or infected which may lead to more severe symptoms such as nausea, vomiting, and fever.

Newer laparoscopic techniques require only keyhole incisions and the recovery period is much shorter.

Before the procedure, an intravenous line will be started and you may be given a sedative to help you relax.

Laparoscopic cholecystectomy is done under general anesthesia, which will put you to sleep for the duration of the operation.

This will relax the muscles of the abdominal wall allowing your surgeon room to work.

A breathing tube will be temporarily inserted through your mouth and into your throat to help you breathe during the operation.

You may also have an orogastric tube placed through your mouth an into your stomach to help drain fluids produced there.

Most cases take between thirty and sixty minutes to perform.

To gain access to your gallbladder and surrounding structures, your surgeon will use sharp instruments called trocars to create a series of small holes, or ports, through your abdominal wall.

One of these ports is usually located at the naval or umbilicus.

Carbon dioxide gas is then pumped through the umbilical port to pump up your abdomen so its contents can be viewed more easily.

Next, your surgeon will insert the laparoscope through the umbilical port.

Images from its camera are projected onto a video monitor in the operating room.

Using other instruments passed through the various ports, your surgeon will grasp the gallbladder, clip off its main artery and duct, drop it into a specimen bag and remove it through one of the ports.

Before removing the laparoscope, your surgeon will take one final look around for areas of bleeding or other damage.

When the laparoscope is removed, a port valve is left in place briefly to allow all the carbon dioxide to escape from the abdomen.

Finally, the keyhole incisions are closed with sutures or staples and covered with bandages.

After the surgery, your breathing and oral gastric tubes will be removed and you will be taken to the recovery area for monitoring.

You will be given pain medication as needed and will progress slowly from a liquid to a soft to a solid diet.

Your intravenous lines will be removed once your gastrointestinal system recovers.

Most elective cholecystectomy patients can leave the hospital within twenty-four hours.

Patients with infected gallbladders may need to stay one or two more days.