What is Cholecystectomy
The cholecystectomy is a surgical treatment of removing the gallbladder. Laparotomy, subcostal incision or laparoscopy can perform it. It is a gentle operation, and if the patient's condition allows, it takes place on a day, an example is when a patient enters the hospital in the morning to be operated, and returns home at the end of the day, after the agreement of the surgeon and the anesthesiologist.
What is the gallbladder?
The gallbladder contains bile excreted by the liver. Food intake stimulates the contraction of the gallbladder and causes the bile to flow through the bile duct and bile duct to the digestive tract. However, the removal of the gallbladder has no consequence on the digestive function: the bile flows continuously from the liver to the gastrointestinal tract, and this flow is sufficient for digestion. The contribution related to vesicular contractions is not essential.
In what circumstances is there a cholecystectomy?
Specific factors such as female sex, hypercholesterolemia, or overweight promote the formation of stones in the gallbladder ( cholelithiasis ). These are very common and do not in themselves constitute a sufficient reason to perform a cholecystectomy.
On the other hand, these stones are likely to obstruct the canal connecting the gallbladder to the bile duct, thus causing a particularly troublesome typical abdominal pain evolving in the form of repeated seizures. The existence of these symptoms associated with the presence of stones in the gallbladder justifies a cholecystectomy.
Complete and prolonged obstruction can lead to inflammation of the entire gallbladder, called cholecystitis, resulting in pain and fever. A cholecystectomy must then be performed urgently, and antibiotic treatment is given to the patient.
How is Cholecystectomy going?
The gallbladder is confined to the lower part of the liver. It is connected to the bile duct by a fine canal called the cystic duct. The bile duct connects the liver to the digestive tract and allows the passage of bile (produced by the liver and used for fat absorption) in the digestive tract. A small artery vascularizes the vesicle called a cystic artery.
Laparoscopy most often performs the removal of the gallbladder. Small incisions of 5 mm to 10 mm are used to pass a camera and long instruments into the abdomen. The surgeon operates by looking at a screen. This avoids a large scar and promotes a return to activity faster by reducing postoperative pain.
The first step of the procedure is to identify the canal and the cystic artery, which are then closed with clips and cut, taking care not to injure the bile duct. The second step is the section of the connections between the gallbladder and the liver. The procedure ends with the extraction of the gallbladder with a bag and the closing of the small incisions.
What are the risks of this procedure?
Like any intervention, cholecystectomy carries some risks, in addition to those related to general anesthesia. The first risk is that of conversion, that is to say, the passage from laparoscopy to the open path. It is not a complication in itself and is usually required when there is significant inflammation around the vesicle preventing the identification of anatomical structures.
A wound in the main bile duct can occur in less than 1% of cases and most often requires reoperation. Bile leakage through the cystic duct or hemorrhage from the cystic artery can also happen: these complications may require a drain or reoperation. These complications, however, remain rare and can, in any case, be treated.
After the operation
Usually, a few days are enough for a complete recovery and a return to a healthy life. The removal of the gallbladder has no impact on digestion, and no change in diet is required.
No specific follow-up is necessary: new gallstones can occur, but these cases of recurrence are sporadic.
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