Gall Bladder Removal Surgery (Cholecystectomy)

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.