Cholecystectomy: How is the Procedure and Possible Risks and Complications

It is a gallbladder removal procedure performed primarily to treat gallstones.

This can be done using the traditional open technique or the minimally invasive method. The gallbladder is a bag-shaped or pear-shaped organ that collects and stores bile, a digestive fluid produced by the liver.

Who should undergo this procedure and what are the expected results?

Cholecystectomy is often done when gallstones form in the gallbladder.

The gallstones are a fairly common problem and is thought to develop due to the imbalance of the compounds found in bile, especially the cholesterol level.

Some suggest that eating foods high in cholesterol may be the reason, but studies suggest that there is no specific diet that can prevent or reduce the risk of gallstones.

Gallstones can also occur due to high amounts of bilirubin in the bile.

The excessive level can be caused by damage to the liver, which breaks down red blood cells. It could be that the liver is already experiencing scars (cirrhosis) or there is a tumor growing in the organ. It is also possible that the bile ducts are infected.

The stones appear in different colors, which may indicate the possible reason for their formation. If they are pigmented, they may have developed due to high bilirubin.

If they are yellow, they are caused by high cholesterol. A patient may also have mixed gallstones.

Gallstones have several risk factors such as age, ethnicity, obesity and sex. They are more common among women since estrogen contains cholesterol.

A patient can develop and accumulate gallstones without realizing it. Symptoms usually appear when stones begin to block the bile ducts or there is already an infection.

Some of these symptoms include abdominal pain, fever, indigestion, itchy skin, loss of appetite and jaundice (yellowing of the skin and eyes).

A person can undergo gallbladder removal surgery with hardly any problem with digestion.

However, some may experience swelling, problems with bowel movement and a reduced ability to absorb fat-soluble vitamins.

How does the Cholecystectomy procedure work?

As mentioned above, cholecystectomy can be performed through the open or traditional or laparoscopic (keyhole) method.

To help the surgeon decide, various tests will be carried out, including blood tests that can determine the general function and health of the liver and other vital organs.

An imaging test can also be useful to know the exact position of gallstones, the condition of the bile duct and gallbladder, and the most ideal surgical procedure for the patient.

In general, open surgery is recommended if the patient needs a liver transplant, there is a significant scar in the area or if the patient has already had surgery on the liver, bile duct or gallbladder previously.

A consultation is also needed to prepare the patient, who will be advised to stop smoking a few weeks before surgery and stop taking medications that may increase bleeding or prevent coagulation.

The surgeon will also discuss the risks and complications of the procedure, possible outcomes, follow-up care, and nutrition after the gallbladder has been removed.

In the case of open surgery, a large incision (about 6 inches) is made in the belly area to fully expose the liver and gallbladder. The gallbladder is then separated using tools, such as electrocautery, before sutures are used to close the incision.

If the surgery is performed with laparoscopic methods, four small incisions are made in the abdominal area. The air is used to expand the abdominal cavity while inserting a laparoscope, a probe with a camera and a light into one of these incisions.

The camera offers images of the organs in real time to a monitor to guide the surgeon during the operation. Using microsurgical instruments, the gallbladder is removed and the incisions are sutured.

In both procedures, the patient receives general anesthesia. In general, anticoagulants and antibiotics are administered to the patient before surgery to minimize certain risks, such as infection and bleeding.

The operation may take about one hour to complete. Patients who have undergone open surgery are usually advised to stay in the hospital for up to five days so their condition can be monitored closely.

Meanwhile, patients with “keyhole” surgery are allowed to go home after spending the night in the hospital.

Possible risks and complications

A surgical removal of the gallbladder can cause hemorrhage, infection and pain. These risks are more likely to occur in open surgery than in a laparoscopic procedure.

Other possible complications are leakage of bile, injury to other organs such as the intestine, inflammation of the pancreas and development of blood clots. There is also a small chance that sepsis will develop.

Sepsis is a life-threatening condition characterized by systemic inflammation that can cause organ failure or damage.