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Gall Bladder Removal

Alternate Names

  • cholecystectomy
  • laparoscopic cholecystectomy
  • Gallbladder removal (cholescystectomy)

Definition

Gallbladder removal, or cholecystectomy, is surgical removal of the gallbladder.

Who is a candidate for the procedure?

A person who is having gallbladder symptoms should discuss this procedure with his or her healthcare professional.
There are several reasons that the gallbladder can become inflamed. Sometimes gallstones form in the gallbladder. These stones can block the drainage of bile, a fluid that helps digest fat and excrete certain fatty materials into the stool. If the ducts for bile excretion become blocked by a gallstone, a person will usually feel pain in the upper right part of the abdomen.
About eighty percent of people who have gallstones have no symptoms. Some people will have a gallbladder that does not have stones but still does not drain well. This is called biliary dyskinesia. It may also treated by removing the gallbladder, but usually only if it also has symptomatic stone disease.
Certain other individuals such as children, or those of a specific race (Pima Indians, or other people with large gall stones, because they have a slightly higher risk for gall bladder cancer) may need the gall bladder removed even in the absence of symptoms..

How is the procedure performed?

Gallbladder removal is one of the most frequently performed operations in developed countries. It can be done either as open surgery or with a laparoscope
Open surgery without a laparoscope through a larger incision is the older and more traditional way to remove a gallbladder. An incision is made in the right upper part of the abdomen a few inches below the rib cage (or occasionally down the center of the abdomen).
The surgeon cuts all the way through the abdominal wall. This lets him or her look at the abdominal cavity for any other problems. The liver is lifted up toward the chest so that the underside can be seen. The gallbladder is then cut away from the liver and removed. The abdominal wall is stitched together and bandaged.
Laparoscopic gall bladder removal has become the most preferable approach. It can be performed safely in most hospitals with little risk to the individual and a shorter recovery time. Like open surgery, this approach requires general anesthesia, which puts the person to sleep.
The navel is opened with a 1-cm incision. The abdominal cavity is filled with carbon dioxide gas to move organs and intestines away from each other and make them easier to see. A video camera built like a tiny rod is inserted through the incision. Three smaller incisions are made in the abdomen. The same process is then used as in the open procedure, but through a smaller entry site.
The surgery is done using smaller instruments than for the open procedure. The air is removed from the abdominal cavity after the gall bladder is removed. The cuts are stitched and bandaged.
Open surgery may be needed if the gallbladder is severely inflamed or infected. This may make it too swollen to be grasped by the tiny instruments. If the person has internal scarring or has had extensive surgery, the abdomen may not inflate well when the gas is put in. This makes it difficult to see the gallbladder well.
Sometimes the anatomy of bile ducts or blood vessels makes them difficult to operate on through the laparoscope. These reasons may make it necessary for the surgeon to change from a laparoscopic approach to an open approach during the operation. This happens in about 5% of cases.

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