Cholecystectomy

What is it?
Cholecystectomy is a minimally invasive surgical procedure that is usually performed to remove the gallbladder.

The gallbladder is a small organ found under the liver, usually on the upper right side of the belly or abdomen. The gallbladder stores a digestive juice called bile that is produced by the liver.

When is it needed?
The doctor usually recommends a cholecystectomy if the patient has any of the following conditions:

• Gallstones in the gallbladder
• Cholangitis: inflamed bile ducts due to gallstones
• Cholecystitis: Gallbladder inflammation
• Pancreatitis: Pancreas inflammation due to gallstones

The patients suffering from ailments of the gall bladder suffer from the following symptoms:

• Pain
• Nausea or vomiting
• Fever or chills
• Chronic diarrhea
• Jaundice
• Lighter-colored stools and dark urine
• Sharp pain in the upper right part of the abdomen that goes to the back, mid-abdomen or right shoulder

Diagnosis
The doctors diagnose issues with the gall bladder by conducting the following diagnostic tests:

• Blood test
• Ultrasound
• MRI HIDA Scan: is the test where a radioactive chemical is inserted into the body and images are taken to track any blocked ducts.
• Endoscopic ultrasonography: is the diagnostic test where an imaging device is inserted into the digestive tract through the mouth and sound waves are used to create a detailed image of the small intestine.

 Procedure
Cholecystectomy can be performed using the following surgical techniques:

• Open Surgical Technique method. 
  Open cholecystectomy is usually required instead of laparoscopy in the following cases:
  
  • Major scarring from a previous surgery.
  • A bleeding disorder.
  • In cases where it is difficult to view through a laparoscope

A general anesthetic is first administered to the patient to relax their muscles, prevent pain, and help them fall asleep. A single cut is then made below the right side of the rib cage or within the center of the abdomen.

This will allow the doctor to see the gallbladder and surrounding anatomy through the cut. The gallbladder is then cut away from surrounding tissue. The blood supply is tied off and divided.

Sometimes a cholangiogram might be done to check for stones in the common bile duct. If there are stones in the common bile duct, they will also be removed at this time. The skin is then closed using the surgical clips and stitches.

Laparoscopic method. 
This method uses three to four very tiny incisions and then carbon dioxide gas is inserted through one of the incisions to swell up the abdomen allowing the doctor to see the gallbladder and nearby organs clearly.

The surgeon will then insert an extended, thin tube called a laparoscope. The tube has a tiny video camera at one end. The tube, camera, and tiny specialized surgical tools are put in place through the incisions.

The surgeon performs the surgery while observing a TV monitor. The gallbladder is removed through one of its incisions. The carbon dioxide gas is then let out through the incisions, most of which will be reabsorbed by the body.

Post-Procedure
Patients who underwent open surgery might have to stay in the hospital for a few days afterward. It might take around 6 to 8 weeks for the body to heal completely.
Patients who underwent laparoscopy have lesser pain and will heal faster than those who underwent open surgery. In most cases, they can leave the hospital in a day or a few hours depending on the patient. They can also resume their normal activities within 2 weeks.

Risk Factors
There might be a few risk factors that occur in rare cases, including,

• Bile leak
• Bleeding
• Blood clots
• Heart problems
• Infection
• Injury in the bile duct, liver, and small intestine
• Pancreatitis
• Pneumonia