Cholecystectomy

Before surgery is recommended, the patient may undergo a series of exams and tests to determine the severity of the problem.

Besides a complete physical exam, a patient may also require:

• Blood tests and complete blood count
• Liver function tests
• Coagulation profile
• Abdominal ultrasound
• Cholescintigraphy (a test which evaluates possible obstruction)
• Endoscopic retrograde cholangiopancreatography (ERCP) which diagnoses and treats problems with the biliary or pancreatic ductal system
• Magnetic Resonance Cholangiopancreatography (MRCP) which is an MRI for the bile ducts Upon completion of all testing and exams,

Upon completion of all testing and exams, if a surgery is required there are two methods to remove the gall bladder: laparoscopic and open.

In a laparoscopic surgery (more than 90%), small incisions are made through which a narrow tube called a port is placed. Carbon dioxide is then pumped into the opening allowing the surgeon to see surrounding organs. The gallbladder is removed through this opening, and the area is closed with sutures or glue. The surgery typically take less than an hour.

During an open operation, an incision is made along the upper abdomen. The gallbladder is removed and the site is stapled or sutured closed. This process takes from 2-3 hours to complete.

Upon waking up from anesthesia, the patient may be able to start drinking small glasses of water. If the patient is not feeling sick, eating may also be allowed. It will be important to continue to drink 8-10 glasses of water per day while recovering. A high fiber diet is also prescribed in order to ease potential pain from bowel movements.

Patients are urged to gradually increase activity levels and get up every hour or so to prevent blood clots.

Immediately following surgery, and depending on the type of pain medicine, a patient may feel out of sorts for 2-3 days. Full recovery can take up to 6-8 weeks. Some patients are able to return to work after 1 week, as long as no heavy lifting takes place. Heavy lifting and strenuous activity is not allowed for up to 6 weeks after surgery.

Complications that may possibly arise include:

• Injury to the bile duct
• Bleeding
• Infection

There may be other risks due to the condition of the patient. Concerns should be addressed with the surgeon before the procedure. Patients experiencing any of the following should contact their doctor immediately:

• Fever/chills
• Swelling, redness, or bleeding at the incision site
• Increased pain at the incision site
• Abdominal pain or swelling
• Pain behind the breastbone