Gallbladder Surgery

Gallbladder Surgery

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Gallbladder Surgery
Gallbladder Surgery
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The gallbladder surgery is performed for the removal of the gallbladder and it is one of the most common surgical procedures. First of all, you should know that the gallbladder is an organ shaped in the form of the pear, located next to the liver. The importance of the gallbladder lies in the fact that is collects the bile produced by the liver, thus aiding the process of digestion. Bile travels to the small intestine through the bile ducts.

The most common method for gallbladder surgery is using a laparoscope and the good news is that the removal of the gallbladder does not impair digestion in any way. The procedure is recommended in patients who have many gallstones, these causing upsetting symptoms, including pain. The gallbladder might also suffer from dysfunction, requiring removal as well. The most common symptoms that can indicate the need for gallbladder removal are: indigestion, pain after eating (epigastric pain), nausea and vomiting.

What are gallstones?

These are masses that can either form in the gallbladder or in the bile ducts, consisting of bile salts and hardened cholesterol. There is no exact cause why these gallstones form in certain cases and there are no specific methods to prevent them from being formed. The symptoms caused by these gallstones are because they actually block the bile from coming out of the gallbladder and, if the common bile duct is blocked, then the patient might also present a yellow color of the skin (jaundice).

Procedure

Gallbladder Surgery
Gallbladder Surgery Pictures

The gallbladder surgery can be performed in two ways:

Laparoscopic gallbladder surgery

  • The gallbladder is removed using a laparoscope
  • This procedure is done under general anesthesia
  • Small incisions are made into the abdomen and the laparoscope is placed inside the body
  • Gas will be pumped inside the body, allowing for a better visualization of the gallbladder and the bile ducts.
  • The gallbladder will be then removed.
  • The doctor might also decide to perform a cholangiogram (dye is injected into the common bile duct) in order to visualize any gallstones in the common bile duct and remove them as well.

Open gallbladder surgery

  • A large cut will be made into the abdomen, on the right side, just below the ribs
  • This procedure is done under general anesthesia
  • The gallbladder will be visualized and separated from the rest of the organs
  • The bile duct and the blood vessels that lead to the gallbladder will be cut
  • The gallbladder will be then removed
  • The doctor might also decide to perform a cholangiogram (dye is injected into the common bile duct) in order to visualize any gallstones in the common bile duct and remove them as well.

Cost

The cost of the gallbladder surgery depends on the location, the clinic and the doctor performing the surgery. Also, it should be mentioned that the price of the laparoscopic surgery is considerably higher than the one of the open surgery, because of the surgical instruments used for the actual procedure. The costs might also be higher if complications arise during or after the procedure, requiring specific medical treatments or care.

Because the gallbladder surgery is not a medical emergency, you might opt to have the surgery in a place where it is cheaper. In the United States, for example, the average sum of gallbladder surgery in New York is of almost $50.000 while the same surgery in Maryland can be done for $10.000. This has nothing to do with the quality of the procedure but rather with the different insurance companies and their policies.

Complications

These are the most common complications of gallbladder surgery:

  • Infection at the site of the operation – the patient will have to follow a treatment with antibiotics to eliminate the infection.
  • Internal bleeding
  • The common bile duct can be injured during the surgery. Immediate repair can be attempted but if this is not successful, then a second corrective repair surgery might be scheduled
  • The small intestine can be injured as well during the surgery
  • Allergic reactions to general anesthesia. These can range from common reactions such as dizziness, vomiting and nausea to severe anaphylactic reactions with difficulty breathing and swallowing and vascular collapse, requiring immediate medical attention and emergency treatment
  • During the surgery, gallstones may enter into the abdominal cavity and remain there, causing additional problems
  • Bile can leak into the abdominal cavity. The excessive bile can be drained but sometimes an additional surgery will be removed to wash the abdominal cavity
  • The blood vessels in the abdomen can be injured during the surgery. In rare cases, the hepatic artery that carries blood from the heart to the liver can be injured
  • The gallstones can be pushed into the common bile duct
  • The liver can be injured by the surgical instruments used during the gallbladder removal procedure
  • Pain in the abdomen
  • Bloating and gas
  • Accelerated intestinal transit
  • Deep vein thrombosis – this happens when blood clots develop during surgery and they usually appear in the legs.

Recovery time

The recovery time for the gallbladder procedure depends on the actual method that is being used. If the gallbladder is removed using a laparoscope, then the patient might be recommended to stay for one or two days in the hospital. Return to normal activity is usually achieved in ten days. In two or three weeks, the discomfort caused by the operation disappears and the patient will be able to feel alright once again.

Open gallbladder removal takes considerable longer to recover, especially since there was a large incision made to the abdomen. The patient will have to spend two or three days in the hospital and full recovery is believed to be obtained in a period of four to six weeks.

Recovery diet

These are the indications for the recovery diet after gallbladder removal:

  • The meals you are going to eat will have to be smaller in quantity and more frequent
  • Recommended choices of foods include poultry, fish, dairy products that are low in fat, fresh fruits and vegetables,         whole grains
  • Avoid foods that have a high fat content, as these can really cause serious problems. It is better to stick with non-fat or low-fat types of foods and carefully calculate your fat intake per day
  • You need to gradually increase the fiber quantity in your diet. However, you have to be careful not to add too much fiber or you will suffer from bloating, gas and abdominal cramps. Fibers are recommended to improve the intestinal transit but only in certain quantities
  • Avoid caffeine based drinks as may be difficult to digest a period after the surgery. The same goes for dairy based products
  • Fried foods are not recommended and you need to stay away from them, especially French fries and potato chips
  • Other foods that you need to avoid are: bacon, sausage, cheese, ice cream, milk, sour cream, pizza, butter, fatty creams and sauces, meat gravy, chocolate, oil (especially palm or coconut), chicken or turkey skin
  • The following types of foods will have to be slowly introduced into the diet: nuts, seeds, Brussels sprouts, broccoli, cauliflower, cabbage
  • Spicy foods are to be avoided, as they can cause upsetting gastrointestinal symptoms
  • Take a daily probiotic supplement, as these friendly bacteria can help you digest food better
  • Brown rice can help you have firm stools and regular bowel movements
  • Lentils and beans are also recommended in certain quantities.
  • Try to have at least four servings of fruits and vegetables per day and at least four servings of breads and cereals as well.
  • Avoid sugary drinks, as these can accelerate the intestinal transit.
  • Tea is not recommended during the initial recovery period, especially the black tea variant.
  • The bland diet is recommended during the initial recovery period, consisting of food such as toast, rice, bananas, lots of soups and pasta.
  • The low fat diet includes skim milk, non-fat yogurt, boiled meat (fish or poultry), water and broth soups.
  • Avoid foods that have a high content of salt.
  • Stay away from pastries, doughnuts and other cookies.
  • Choose healthy fats that are contained in the olive and fish oil.
  • Drink fresh fruit or vegetable juice in the morning, as this will help with the digestion. Oatmeal is also recommended for breakfast along with fresh fruit and non-dairy milk.
  • You can snack on fresh fruits and nuts (almonds for example).
  • Vegetable snacks are also delicious (bell peppers, carrots, celery, cucumbers).

Video

Watch the video to have a general idea of how the laparoscopic gallbladder removal surgery is performed:

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