Laparoscopic Cholecystectomy

Gallbladder Surgery:
Gallbladder disease is very common and can be due to gallstones or to functional problems of the gallbladder.
Symptoms of gallbladder disease are typically right upper quadrant abdominal pain, often after meals, particularly with fried and greasy food. Gallbladder attacks are frequently associated with nausea and possibly vomiting. The pain can radiate to the back or right shoulder. Atypical symptoms are relatively common and can include pain in other parts of the abdomen although lower abdominal pain is extremely rare. Nausea can be present without pain. The pain can localize into the chest and may be mistaken for heart disease or reflux disease. Gallstones (cholelithiasis) are more common and generally more dangerous than functional (acalculous) disease because gallstones can cause more severe problems such as:
*acute inflammation (cholecystitis)
*jaundice
*bile duct obstruction
*pancreatitis
Gallstones can be reliably diagnosed with an ultrasound examination. Symptomatic gallstones are almost always an indication for removal of the gallbladder (cholecystectomy). Other treatments have been tried unsuccessfully.

Functional gallbladder disease is known under various names such as chronic acalculous cholecystitis, acalculous cholecystopathy, biliary dyskinesia etc. Frequently a HIDA scan may show a malfunctioning gallbladder but often all tests may be normal. This condition is not inherently dangerous and the indication for a cholecystectomy depends entirely on the severity of the symptoms.

The Operation:
A cholecystectomy can usually be performed laparoscopically through very small incisions and with the help of a camera, which results in much quicker recovery and less pain postoperatively. The expected hospital stay ranges from three to five days for an open cholecystectomy and from three to five hours if performed laparoscopically. However as with any laparoscopic procedure there is a 2 – 5 % chance that a conversion to an open operation may become necessary. Certain conditions such as severe inflammation or scarring around the gallbladder, significant bleeding, previous operations, obesity and a variety of other anatomical or technical problems can make it unsafe or even impossible to complete a laparoscopic operation.

Recovery:
Most patients can go home the day of the operation. Heavy lifting, strenuous work or vigorous sports should be avoided for about three weeks. Some patients go back to work in three days.




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