Cholecystectomy, or gallbladder surgery, is one of the most common surgical invasions. When open surgery is performed, the gallbladder is removed via a big incision in abdomen. The aim of the operation is to eliminate discomfort connected to the gallstones appearing in a bladder.
The purpose of the gallbladder is to accumulate bile. The bile is needed to digest the fats, but bile can thickening and create the blockages, and there are some hard substances in the gall that are stay in gallbladder and became a base of growing gallstones. Gallstones cause the pain and, finally, become disturbing condition. They could cause infections and gallbladder attack.
Gall bladder attack is a sudden acute pain, which is spreading in the right shoulder blade area. Sometimes this condition could worsen with the symptoms of acute cholecystitis as fever, nausea, vomiting. The other symptoms are:
- Abdominal Pain;
- Pain After Meals;
- Whites of the Eyes Yellowing;
- Yellow Skin;
- Tightness of abdomen.
To avoid those unpleasant effects, a removing of the gallbladder together with the stones are performed. There are also some other causes of removing of the gallbladder.
Indications to Cholecystectomy are:
- Biliary dyskinesia;
There are two main techniques to treat the gallbladder:
- Open surgery
It is approximately 5-10 % when open rather than laparoscopic surgery for gallbladder is required. It is often performed in a complex treatment or when there are other complications, as inflammation, bleeding, and injury.
The laparoscopy is preferable always when possible but classical method through the big abdominal incision is also used.
The minimally invasive method is very popular for gallbladder removal. There are only two small punctures to input a laparoscopic tube with a camera and thin surgical instrument inside. After that, surgeon inflates an abdominal area with carbon dioxide to create operating space. Investigating inner space be means of camera which translates the images to monitor, the surgeon make removal of the gallbladder.
After finishing he lets carbon dioxide out and finalizing the operation sewing the cuts. Sometimes when gallbladder disease is not severe, endoscopic retrograde cholangio-pancreatography is used. This is diagnostic procedure but if the gallstones are found during examination they could be accurately removed. Rarely, surgeon starts minimally invasive surgery but is not able to remove the gallbladder out; in this case, he/she switch to open surgery method.
The benefits of laparoscopy:
- Quick recovery;
- Smaller scars;
- Less blood;
- Less pain.
It takes about a week or more to return to the normal activities, maybe, less for patients who had laparoscopy. There is no special diet.
During a several months after cholecystectomy the patient could experience the old signs as gallbladder is still there. It is a paradox, but you should have the same symptomatic treatment as before when having gallbladder attack. How is it possible? It easily could mean that the stones are still presented but now in a bile duct, that is called choledocolithiasis. Treatment of this condition could be done with endoscopic retrograde cholangio-pancreatography.
With removing the gallbladder the problem of the bile stones is not removed, as it is could appear in liver and bile duct.
The regulation of bile is impaired, sometimes you could have too little bile produces or, opposite, is too much, which is harder to control.
There are some other effects, but the main thing is that you should think enough before having gallbladder removal, as the same signs could be a result if different diseases and getting cholecystectomy you might have all the problems again but without gallbladder.
For successful treatment, it is very important to choose a right place for the procedure, where you could have complete examining with a specialist. The many German hospitals have specializes liver centers which treats with the problems of the liver, bile ducts, gallbladder using the comprehensive methods. The precise diagnostic is a base of the correct treatment, sometime it is difficult to make a choice between surgery and non-surgical methods. If you have some doubts, please apply for a consultation in one of the clinics in Germany.