Gall Bladder Removal Surgery
Surgery done to excise the gall bladder because of some health condition comprises gall bladder
removal surgery. Gall bladder is an organ situated next to liver in the human body. It is
responsible for storing a liquid knowns as bile. Bile is synthesized by the liver and helps in
digesting the food after it enters the small intestine from stomach. Bile is secreted out through a
tube like structure known as cystic duct. It joins a similar tube arising from the liver known as
hepatic duct. Both these ducts join to form a common bile duct. This, along with a similar duct
arising from the pancreas, open into the small intestine where they secrete digestive fluids. This
helps further digestion after partly digested food has been received from stomach.
Gall bladder removal surgery is done when the gall bladder functions abnormally due to some disease.
It can be done laparoscopically or by open method. The procedure lasts for about 45 minutes to 1
hour.
Methods/Techniques of Gallbladder Removal Surgery
Gallbladder removal surgery or cholecysectomy as it is known, can be done by the old school open
method, or the newly developed minimally invasive laparoscopic method. Both methods have their own
pros and cons. The procedures have been described below in detail:
- Open Method :
The open method is an invasive one and begins with a single surgical incision 4-8 inches long
made below the skin covering the rib cage on right side of abdomen. Alternately, a large
vertical incision may be made at the center of the abdomen. After the skin has been cut,
underlying fat and fascia is removed. Abdominal muscles are separated till the liver can be
visualized. The gallbladder is present hidden beneath the liver when the patient is lying flat
on the back. Liver may have to be retracted to visualize the gallbladder completely. After it
has been isolated, the attachments of the gallbladder to other abdominal structures are
carefully cut. Blood vessels which have been accidentally cut are sealed using chemicals or
minute electrical currents. The cystic duct is clamped and gallbladder is separated form it.
After it is removed, the liver, abdominal muscles which were retracted are returned to their
original position. Skin incision is closed with a medically designed thread.
Open surgery has a few disadvantages. Due to a large incision made during the procedure, the
risk of bleeding, infection and delayed recovery are increased. But there are a few advantages
as well. Certain health conditions like cancer of gallbladder, portal hypertension (increased
pressure of the blood in the vessels inside liver), severe inflammation of gallbladder,
necessitate open cholecystectomy only. It is risky to perform a laparoscopic surgery if these
conditions are diagnosed. The procedure lasts for about 1-2 hours
- Laparoscopic method :
A newer method as compared to open method, laparoscopic cholecystectomy is a minimally invasive
surgery. As opposed to open surgery, this method involves the use of smaller and multiple
incisions over the abdominal wall. After the incisions are made, the surgeon inserts a video
camera attached to a long tube, known as a laparoscope inside through one of the incisions.
Surgical equipment is inserted inside through the other incisions. Further process remains the
same as the open surgery.
After the gallbladder has been extracted, the surgeon will close all surgical incisions. Since
the incisions are very small, they heal faster and do not leave permanent scars. The risk of
accidental damage to any blood vessel or other organs while making the incision is minimized.
Because there is minimum exposure of the abdominal organs, risk of infection also reduce
greatly. However, many a times, laparoscopic surgery fails to show success. In such cases, the
surgeon may have to proceed to the open method to remove the gallbladder. The procedure lasts
for about 45 minutes.
Both the methods vary slightly in the way they are performed; however, end result is same in
both the procedures. If there is suspicion of cancer, then the gallbladder can be sent for
pathological examination. After the surgery, there is a recovery period of about 4-6 weeks
during which patient has to take utmost care of their health. Recovery period is shorter after
laparoscopic surgery.