Laparoscopic cholecystectomy, commonly referred to as a lap chole, involves the removal of the gallbladder through a laparoscopic approach. The gallbladder normally stores bile produced in the liver until it is needed for digestion. Unfortunately, the gallbladder often forms gallstones.
How is gallbladder disease diagnosed and treated?
Ultrasound method is the most commonly and firmly used test to find gallstones, though more investigations including like MRI or endoscopic ultrasound (EUS),hepatobiliary iminodiacetic acid (HIDA),ERCP may be done. You will also need some blood investigations done to ensure that the liver function is normal.
- Gallstones do not go away on their own. Some can be temporarily treated with the help of drugs or by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed.
- Laparoscopy removal of the gallbladder is the time honoured and safest treatment of gallbladder disease.
Who needs a Cholecystectomy?
Patients with gallstones and symptoms as mentioned above should have a Laparoscopic Cholecystectomy, before they develop severe other complications. Occasionally patients without gallstones, who have significant symptoms, will require a Cholecystectomy. Rarely, patients with large gallbladder polyps (growths) will have a Cholecystectomy because of the possibility of developing gallbladder cancer.
How it is performed?
- Laparoscopic cholecystectomy – ‘keyhole’ surgery . The surgeon makes a number of small incisions (cuts) through the skin, allowing access for a range of instruments. The surgeon removes the gallbladder through one of the incisions.
About some of cases the gall bladder cannot be safely removed laparoscopically and a traditional open technique is required (laparotomy). This requires a 15 cm incision in your upper abdomen parallel to your right rib cage. This is a bigger procedure and will result in a longer hospital stay.
The surgeon makes a number of small incisions into your abdomen, so that slender instruments can reach into the abdominal cavity.
A tube blowing a gentle stream of carbon dioxide gas is inserted. This separates the abdominal wall from the underlying organs.
The surgeon views the gallbladder on a TV monitor by using a tiny camera attached to the laparoscope.
Special x-rays (cholangiograms) during the operation can check for gallstones wedged in the bile ducts.
The ducts and artery that service the gallbladder are clipped shut. These clips are permanent.
The gallbladder is cut free using either laser or electrocautery.
The gallbladder, along with its load of gallstones, is pulled out of the body through one of the abdominal incisions.
The instruments and the carbon dioxide gas are removed from the abdominal cavity. The incisions are sutured (closed up) and covered with dressings.
- Open gallbladder surgeryThe general procedure is the same as for laparoscopic surgery, except that the surgeon reaches the gallbladder through a large, single incision in the abdominal wall. Sometimes, an operation that starts out as a laparoscopic cholecystectomy turns into open surgery if the surgeon encounters unexpected difficulties, such as not being able to see the gallbladder properly.
Is there are any side effects of gall bladder removal on body?
Removal of gall bladder does not cause any side effect or problems in digestions on long term. Gall bladder function as a storage for bile and not involved in production of bile. Hence removal does not cause any side effects on the body.